missouri wic program implementation: may 5, 2014
TRANSCRIPT
![Page 1: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/1.jpg)
Missouri WIC Program
Implementation: May 5, 2014
![Page 2: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/2.jpg)
Identify the four guiding principles of participant-centered communication
Recognize the revisions to the follow-up questions Understand the implementation of the extended certification
periods Identify the procedures required at the Mid-Certification
Assessment (MCA) appointment
![Page 3: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/3.jpg)
![Page 4: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/4.jpg)
![Page 5: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/5.jpg)
Guiding principles
![Page 6: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/6.jpg)
• Guidance • Ask during a face-to-face session
• Responses are used for documentation. • The responses are not meant to be read to the
participant • Counseling staff will evaluate the questions to
determine if it meets a risk factor criteria• Manually assign the risk factor
![Page 7: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/7.jpg)
Prenatal Follow-up Questions #1 No change
What have you heard about breastfeeding?
#2 Revised Tell me about the changes in your eating
habits since becoming pregnant? (Select all that apply)
No changes Improvements Concerns Other/Comments
![Page 8: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/8.jpg)
Prenatal Follow-up Questions#3 Revised (question/responses)
Tell me about the minerals or herbal supplements you take besides prenatal vitamins? (Select all that apply.)
None Calcium Folic Acid Iron Iodine Herbal Other/Comments
Reference 427.1 & 427.4
![Page 9: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/9.jpg)
Prenatal Follow-up Questions#4 change in the responses
What concerns do you have about providing, preparing and/or storing food for your family? (Select all that apply.)
No concerns Insufficient food sources Food preparation (new ideas/doesn’t
know how to cook) Inadequate kitchen appliances Other/comments
![Page 10: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/10.jpg)
Prenatal Follow-up Questions#5 New question
What health or medical issues do you currently have or have had?
Open text box
Allows staff to access for clinical/medical conditions
Risk Factors 341-362
![Page 11: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/11.jpg)
Prenatal Follow-up Questions#6 Revised Question
How would you like to improve your eating and/or physical activity habits? Reminder: Establish a new goal and/or follow-up on a previous goal.
Open text box
You can document the goal here or indicate “see notes” if you want to place them in the general/SOAP notes
![Page 12: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/12.jpg)
Prenatal Follow-up Questions #7 Revised
Optional Documentation: Full name and WIC title of person completing the nutrition
assessment - required
![Page 13: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/13.jpg)
Breastfeeding Women Follow-up Questions #1 Revised (responses)
What concerns related to breastfeeding do you have? (Select all that apply.)
No Concerns Milk Production
lack of milk production, engorgement, etc. Anatomical Breast issues
recurrent plugged ducts, mastitis, flat/inverted nipples, tenderness, etc.
Other/Comments
![Page 14: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/14.jpg)
#2 Revised Tell me about any changes in your eating
habits since delivery? (Select all that apply.) No changes Improvements Concerns Other/Comments
![Page 15: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/15.jpg)
Breastfeeding Women Follow-up Questions #3 Responses revised
Tell me about the minerals or herbal supplements you take? (Select all that apply.)
None Prenatal/Multi vitamin Calcium Folic Acid Iron Iodine Herbal Other/Comments: Reference 427.1 & 427.4
![Page 16: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/16.jpg)
Breastfeeding Follow-up Questions#5 New question
What health or medical issues do you currently have or have had?
Open text box
Allows staff to access for clinical/medical conditions
Risk Factors 341-362
Breastfeeding Women Follow-up Questions#4 change in the responses
What concerns do you have about providing, preparing and/or storing food for your family? (Select all that apply.)
No concerns Insufficient food sources Food preparation (new
ideas/doesn’t know how to cook)
Inadequate kitchen appliances
Other/comments
![Page 17: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/17.jpg)
Breastfeeding Women Follow-up Questions#6 Revised Question
How would you like to improve your eating and/or physical activity habits? Reminder: Establish a new goal and/or follow-up on a previous goal.
Open text box
You can document the goal here or indicate “see notes” if you want to place them in the general/SOAP notes
![Page 18: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/18.jpg)
Breastfeeding Women Follow-up Questions #7 Revised
Optional Documentation: Full name and WIC title of person completing the nutrition
assessment - required
![Page 19: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/19.jpg)
![Page 20: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/20.jpg)
Reference 425.4 & 428
Question #1 - Tell me about your child’s eating habits, appetite, and how the foods are prepared. (Select all that apply.)
Eats well Picky eater Eats age appropriate food and uses age
appropriate utensils Does not eat age appropriate food
and/or does not use age appropriate utensils
Other/comments
![Page 21: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/21.jpg)
Question #2 How do you feel about your child’s
height and weight? Just fine Too little Too big Other/comments Reference RF 113, 114, 134, 135
![Page 22: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/22.jpg)
#4 New question What health or medical issues do
you currently have or have had? Open text box
Allows staff to access for clinical/medical conditions
Risk Factors 341-362
#3 change in the responses What concerns do you have
about providing, preparing and/or storing food for your family? (Select all that apply.)
No concerns Insufficient food sources Food preparation (need
ideas/doesn’t know how to cook)
Inadequate kitchen appliances
Other/comments
![Page 23: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/23.jpg)
#5 Revised Question How would you like to improve your
child’s eating and/or physical activity habits? Reminder: Establish a new goal and/or follow-up on a previous goal.
Open text box
You can document the goal here or indicate “see notes” if you want to place them in the general/SOAP notes
![Page 24: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/24.jpg)
#6 Revised Optional Documentation: Full name and WIC title of person completing the
nutrition assessment - required
![Page 25: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/25.jpg)
System displays the infant questions based on:
Feeding status – health info tab Age Certification vs. Mid-Certification
![Page 26: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/26.jpg)
![Page 27: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/27.jpg)
Question #1 - Tell me about breastfeeding your baby. no concerns feeding on demand less than 8 feedings in 24 hours if less than 2 months old less than 6 feedings in 24 hours if between 2 months and 6 months
old proper storage of breastmilk breastfeeding concerns (sore nipples, etc) other/comments
Feeding Status: Fully breastfeeding and breastfeeding/formula
![Page 28: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/28.jpg)
Question #2 - Tell me about formula feeding your baby. (Select all that apply.)
no concerns formula properly mixed and stored adequate amount of formula and feedings fed on demand other/comments
Feeding status: breastfeeding/formula only
Reference 411.4, 411.6, 411.9
![Page 29: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/29.jpg)
Tell me more about your decision to supplement with formula. (Select all that apply.)
Health Care Provider Low supply (actual or perceived) Personal choice Other/comments:
Feeding status: breastfeeding/formula only
![Page 30: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/30.jpg)
Tell me about your baby’s wet and dirty diapers.
no concerns black and sticky brownish to greenish green and foamy/frothy yellowish and seedy firm hard and pebbly watery other/comments
Feeding status: Fully breastfeeding and breastfeeding/formula
![Page 31: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/31.jpg)
Tell me about any supplements or vitamins you give your baby.
None Infant multivitamin Vitamin D Herbal supplements, remedies, teas Iron Fluoride Other/comments
Feeding status: All feeding optionsReference 411.10, 411.11Nutrition Training Manual – Infant Section
![Page 32: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/32.jpg)
Tell me about any supplements or vitamins you give your baby.
None Infant multivitamin Vitamin D Herbal supplements, remedies, teas Iron Fluoride Other/comments
Feeding status: All feeding options
Reference 411.10, 411.11Nutrition Training Manual – Infant Section
![Page 33: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/33.jpg)
Tell me about any supplements or vitamins you give your baby.
None Infant multivitamin Vitamin D Herbal supplements, remedies, teas Iron Fluoride Other/comments
![Page 34: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/34.jpg)
Revised Question What feeding goals do you have for your
baby? Establish a new goal and/or follow-up on a previous goal.
Open text box
You can document the goal here or indicate “see notes” if you want to place them in the general/SOAP notes
![Page 35: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/35.jpg)
Revised Optional Documentation: Full name and WIC title of person completing the
nutrition assessment - Required
![Page 36: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/36.jpg)
Breastfeeding only = 4 questions
Breastfeeding & formula = 6 questions
Formula only = 4 questions
![Page 37: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/37.jpg)
Tell me about breastfeeding your baby. No concerns Feeding on demand Proper storage of breastmilk Breastfeeding concerns (sore nipples,
etc.) Other/Comments
Feeding status: Fully breastfeeding and breastfeeding/formula
![Page 38: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/38.jpg)
Tell me about formula feeding your baby. no concerns formula properly mixed and stored adequate amount of formula and feedings fed on demand other/comments
Feeding status: breastfeeding/formula and formula only
Reference 411.4, 411.6, 411.9
![Page 39: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/39.jpg)
Tell me more about your decision to supplement with formula.
Health Care Provider Low supply (actual or perceived) Personal choice Other/comments:
Feeding status: breastfeeding/formula only
![Page 40: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/40.jpg)
Tell me about the foods you are feeding your baby.
None No concerns Age appropriate foods Proper feeding methods Other/Comments
Feeding status: All feeding options
Reference 411.4, 428
![Page 41: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/41.jpg)
Tell me about any supplements or vitamins you give your baby. None No concerns Infant multivitamin Vitamin D Herbal supplements, remedies, teas Iron Fluoride Other/comments
Feeding status: All feeding options
![Page 42: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/42.jpg)
Tell me about playtime for your baby. None No concerns Age appropriate activities Other/Comments
![Page 43: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/43.jpg)
Revised Question What feeding goals do you have for your
baby? Establish a new goal and/or follow-up on a previous goal.
Open text box
You can document the goal here or indicate “see notes” if you want to place them in the general/SOAP notes
![Page 44: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/44.jpg)
Revised Optional Documentation: Full name and WIC title of person completing the
nutrition assessment - required
![Page 45: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/45.jpg)
![Page 46: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/46.jpg)
![Page 47: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/47.jpg)
![Page 48: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/48.jpg)
Certification Periods•Infant: To the last day of the month the infant turns one year old•Breastfeeding Woman: To the last day of the month in which her infant turns one year old or until the woman stops breastfeeding•Child: Yearly ending with the last day of the month in which the child turns five years old
![Page 49: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/49.jpg)
New certs for Infants Children Breastfeeding women
Infant is fully breastfeeding Infant partially breastfeeding
< max
![Page 50: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/50.jpg)
• Complete Assessment• Anthropometric Measurements• Bloodwork
• based on bloodwork schedule• Nutrition Assessment – including oral assessment• Immunization Screening (if applicable)• Category/Age Appropriate Nutrition Education• Referrals
![Page 51: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/51.jpg)
![Page 52: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/52.jpg)
• Infant• Done at 9 through 11 months of age
• Children• Between 12 months of age and prior to
their second birthday, recommended at 15-18 months of age.
• Required for the 2-year old certification • Children 24 – 60 months of age must
be taken at least once every 12 months.
Refer to ER# 2.02800
![Page 53: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/53.jpg)
Components:• Review last nutrition assessment & health
information tab
• Address new concerns raised by the participant
• Identify new medical diagnosis
• Identify changes in eating pattern/food intake/food package
• Identify changes in physical activity behaviors
![Page 54: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/54.jpg)
• Agencies may choose an option
1. Initial and follow-up questions
2. Initial and mid-certification questions
3. Mid-certification questions only
![Page 55: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/55.jpg)
Three different sets of questions Initial Questions Follow-up Questions MCA Questions
![Page 56: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/56.jpg)
• Complete Assessment• Anthropometric Measurements• Bloodwork
• based on bloodwork schedule• Nutrition Assessment – including oral assessment• Immunization Screening (if applicable)• Category/Age Appropriate Nutrition Education• Referral
![Page 57: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/57.jpg)
Nutrition education must be offered at the equivalent of one contact for each three months (quarterly)2 face-to-face contacts 2 secondary contacts
Approved Nutrition Education Methods
ER#2.06400 Effective Nutrition Education: Standards, Participant-Centered Goals, Delivery Methods and Documentation
![Page 58: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/58.jpg)
• Complete Assessment• Anthropometric Measurements• Bloodwork
• based on bloodwork schedule• Nutrition Assessment – including oral assessment• Immunization Screening (if applicable)• Category/Age Appropriate Nutrition Education• Referral
![Page 59: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/59.jpg)
• Must be at least six months old and before the last day of the infant’s 11th month
![Page 60: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/60.jpg)
• 60 days prior to her MCA date • No later than the last day of the
certification period
![Page 61: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/61.jpg)
• Up to 60 days prior to the MCA date
• Before the last day of the certification period
![Page 62: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/62.jpg)
MOWINS Participant List Window
![Page 63: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/63.jpg)
![Page 64: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/64.jpg)
![Page 65: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/65.jpg)
![Page 66: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/66.jpg)
![Page 67: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/67.jpg)
• When a pseudo cert is created the system is dropping off several risk factors
• Dietary Risk Factors • Risk Factor 121 Short Stature
![Page 68: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/68.jpg)
• Risk Factor 142 Premature • When a pseudo cert is created
the system is dropping this risk factor
• Not assigning at certification
![Page 69: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/69.jpg)
![Page 70: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/70.jpg)
• Staff orientation regarding MCA • Are staff members able to
apply new skills learned in training to their daily routine?
![Page 71: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/71.jpg)
• When to schedule the participants for their MCA
• Determine how many WIC employees a participant sees during a WIC appointment.
![Page 72: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/72.jpg)
• Who will be involved in the MCA appointment as it relates to the Nutrition Assessment tab
• Agencies may choose an option• Initial and follow-up questions• Initial and mid-certification
questions• Mid-certification questions only
![Page 73: Missouri WIC Program Implementation: May 5, 2014](https://reader038.vdocuments.mx/reader038/viewer/2022110213/56649eaa5503460f94bafe55/html5/thumbnails/73.jpg)