Volume 20, Number 1
Interns Celebrate Graduation
Highlighting a Year of Accomplishment!
New Breastfeeding Resource and Training Center Opens in Houston
2010 Interns Share Experiences and Their Graduation
2011 Interns Share Expectations and Their Goals
Local Agency Spotlight: Corpus Christi Hospital Helps Local Agency Host Health Fair
WIC Wellness Works
Interactive Voice Response System Available 24 Hours
WIC Needs a True Representation of Household Income
Local Agency Directors Reflect on the WCS Training Program
State Agency Spotlight - Angela Gil: Career Path Includes the Texas WIC Dietetic Internship
Paula Kanter: Receives TALWD Award
Test Your Nutrition IQ
Highlighting a Year of Accomplishment!
From the Texas WIC Director
— Mike Montgomery
Welcome to a new year with the Texas WIC Program! This issue of the Texas WIC News focuses on both celebrations of accomplishments in 2010 and new beginnings for 2011. We are proud of our WIC staff and want to take this opportunity to highlight many of those who have contributed to the success of the Texas WIC Program in this past year.
We begin this issue with information on the newly opened Lactation Foundation, WIC Breastfeeding Resource training center in Houston. This center offers an additional breastfeeding statewide resource and provides advanced training opportunities for WIC staff.
Congratulations to the 2010 dietetic interns on their successful completion of the internship program. The hard work of these dedicated individuals concluded with a graduation and reception celebration on September 30. You can read about the 2010 interns and their experiences in the article found on pages 6 through 8. The completion of the internship, followed by the successful passing of the examination to become a registered dietitian can open many career opportunities. The career path for one of our past interns is highlighted in the State Agency Spotlight on page 16.
With the graduation of one class comes the beginning of the internship for another class. You can meet the 2011 interns and learn of their goals on page 9.
Another group of local staff highlighted in this issue are those individuals who are continuing their career advancement by becoming WIC Certification Specialists (WCS). Special thanks go to the agencies and 19 candidates who participated this past year in the WCS training pilot program. You can learn what several WIC directors have to say about the pilot in the article “Local Agency Directors Reflect on the WCS Training Program” on pages 14 and 15.
At the state office level we are proud to highlight our own hard workers. On October 20, Paula Kanter, a clinical nutrition specialist in the Clinic Services Branch was honored by the Texas Association of Local WIC Directors by being awarded the annual Customer Service Award given by this group . You can read about the award as well as what several co-workers have to say about Paula in the article on page 16.
I am very proud of our WIC staff at both the local and state level. It is your dedication to the program and the participants that contribute to our success. Thank you for all you do for the Texas WIC Program.
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New Breastfeeding Resource and Training Center Opens in Houston
by Karen Gibson, R.D.
WIC Director, UT WIC Program
The Lactation Foundation, the new WIC breastfeeding resource and training center has opened through The University of Texas Health Science Center at Houston (UTHealth) WIC Program.
The new center offers free consultation services to WIC moms and provides helpful information for the general community. It will also serve as a location to train WIC staff and other healthcare professionals in breastfeeding management.
The public was invited to the grand opening held Friday, October 22.
Currently 76 percent of WIC mothers initiate breastfeeding, which is higher than the national average according to Karen Gibson, UT WIC Program director and a registered dietitian in the Department of Pediatrics at The University of Texas Medical School at Houston, part of UTHealth.
But breastfeeding difficulties, from latching problems to pain, take their toll and most moms aren’t able to sustain breastfeeding either exclusively or for the duration of six to 12 months (recommended goals of the Healthy People 2010 initiative).
“That’s where the center comes in to support them,” said Alisa Sanders, R.N., a board-certified lactation consultant at UTHealth and manager of the center. “They come in with a lack of knowledge and just need to be reassured. The most common reason they quit is that they think they don’t have enough milk and that’s usually not the case”. Since its opening on October 8 the center has seen thirty patients with a variety of issues ranging from a mom with breast reduction surgery to babies with various health issues such as Down’s Syndrome, Spina Bifida, prematurity, low birth weight and of course, the everyday latch issues.
True to its mission, the center has served WIC mothers not only from its own Local Agency 17 but also from WIC agencies 48 and 84 in the surrounding area. It has answered phone inquiries from other WIC agencies seeking advice on difficult nursing issues that they were dealing with at their own local agency.
In addition to serving moms who are currently breastfeeding, the center has also been contacted by mothers-to-be who were seeking out information on breastfeeding. The center will soon conduct regularly scheduled breastfeeding classes for pregnant moms. The class time will be credited as a Nutrition Education contact for the regular WIC visit.
For those moms who cannot come to the center, the option of using a web cam to counsel moms is being considered. Right now the procedure is being piloted at one of LA 17's clinics, and once it is determined to be helpful it will be offered to all Texas LAs.
One of the center’s main goals is to provide a rich training program for WIC and other professionals so that they can in turn help moms continue breastfeeding. “We want our nutritionists and dietitians to practice counseling moms and have that actual experience before putting their knowledge into action when they go into the field,” Sanders said.
Beginning in January 2011 the center will be an additional location for WIC staff to attend the WIC Clinical Lactation Practicum.
Area health-care professionals who were looking for training opportunities have also contacted the center and there has already been interest for the 4th year medical students from UTHealth to do a rotation through the center. “We are very excited to have the interest from the Medical School,” says Gibson. “Future pediatricians will greatly benefit from an opportunity to learn firsthand at our center about the mother-baby dyad.”
Any mom in Southeast Texas who is seeking information and help can access the center’s resources through the website, www.lactationfoundation.org, their Facebook page or by calling toll free 1-877-550-5008. The Lactation Foundation is open Monday through Friday from 7:30 a.m. to 4 p.m. and two Saturdays a month.
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2010 Interns Share Experiences and their graduation
The 2010 internship concluded on September 30 with a graduation ceremony in Austin. Here's a final look at the class of 2010...
The Texas WIC Dietetic Internship taught Manrique Fuentes the value of time management, communication and networking. The assignments and the whole internship process were demanding yet rewarding because they really helped build the core competencies for a dietetic professional.
“I was exposed to so many different areas in which a dietitian is employed and feel that there are various opportunities available to the nutrition professional,” said Fuentes.
Working closely within his community reinforced Fuentes’ desire to make a difference in his home town.
Flavia Souza Galarraga
Flavia Souza Galarraga believes completing the WIC Dietetic Internship to have been one of the most challenging, yet rewarding experiences in her life.
“It has been an intense 12 months, marked by learning-dense opportunities, intellectual and emotional growth, mental obstacles, and juggling activities. It has made me come to grips with some of my personal limitations, leading me to improve my time-management and organizational skills,” said Galarraga.
“I was blessed to have Mary, Leslie, Ponna, and Tricia as the internship leaders and such a wonderful group of interns,” said Galarraga.
Being accepted into the Texas WIC Dietetic Internship was both exciting and scary for Kelley Williams, a graduate of Texas Tech University. Having the opportunity to complete the Texas WIC Dietetic Internship has been a life-changing experience for Williams in so many ways.
“I don’t really even know how to describe all of the things that I have learned during this year-long, intensive journey into the field of clinical and community nutrition,” said Williams.
Williams hopes to use each and every portion of the learning process to better serve the clients in her local agency.
The Texas WIC Dietetic Internship was a rewarding, learning experience for Brittaney Sparks, a graduate of the University of Kentucky. Challenged during each rotation to try something new and work outside of her comfort zone, Sparks learned to take advantage of her opportunities to learn everything possible.
“I continued to remind myself during the internship to think of myself as a sponge that absorbed the wealth of experience and intelligence of the preceptors I encountered,” said Sparks.
Sparks loved the community focused atmosphere and friendly staff she experienced during the basic and advanced acute care nutrition therapy rotations at Texas Health Harris Methodist Hospital Stephenville.
For Ancy Alexander, the Texas WIC Dietetic Internship was a year of personal and professional growth beyond expectations.
“Dietetics has a reputation for being a ‘helping’ profession and now I understand why. From the school district’s dietitian who tediously selects healthy menus to the one who sees dialysis patients – they all have the same goal – helping people improve their lives,” said Alexander.
Alexander, who grew up in Dallas and attended Texas A&M University in College Station, gained a deep appreciation for the profession.
“I’m so thankful for every person who’s invested time in teaching me and showing me the ropes,” said Alexander.
Alexander, admits that there were triumphs and frustrations weekly, sometimes daily. Her calendar and GPS became her new best friends. Organization and diligence were her new family and relaxation was an acquaintance she saw every once in a while.
Gabriela Gardner considers the WIC Dietetic Internship a great learning opportunity that helped her develop many skills in all areas of dietetics.
“I feel more confident about my nutrition knowledge and my ability to deal with the everyday challenges…,” said Gardner.
Gardner, who is originally from Mexico City, graduated from the University of Houston in August 2007.
She enjoyed her rotations, which included food service in a school district; providing nutrition education to children, teenagers, adults, and seniors; and being at an adult and pediatric hospital.
“All these experiences showed me the great need that our communities have for nutrition experts who can help them achieve their goal on being healthy,” said Gardner.
For Mary Aviles, the Texas WIC Dietetic Internship was an amazing experience!
“I have gained an immeasurable amount of knowledge and skills that I am applying to my personal style,” said Aviles.
Her mentor and preceptors taught Aviles much about becoming a nutrition professional.
“I have learned how important it is to treat everyone with respect and be sensitive to every individual person,” said Aviles, a graduate of The University of Texas at Austin, who participated in a food service rotation, clinical rotations, and an extensive amount of community rotations.
Before starting her internship, Nina Norouzi thought the Texas Dietetic Internship would simply be another educational experience.
“But no, the hard work actually started three months before the internship started. And I tell you ‘IT IS NOT A JOKE!’ You have to be really committed in order for you to complete this program successfully!” said Norouzi.
Norouzi graduated from California State University-Northridge and received a master in public health nutrition from Karolinska University in Stockholm, Sweden.
When Norouzi looks back on her internship, she sees not only all the hard work, but a multitude of learning and unique experiences.
For Vanessa Enriquez the Texas WIC Dietetic Internship was one of the most challenging, but fulfilling things she had ever done.
“I remember being accepted to the program last year and thinking about how September 2010 would never get here...,” said Enriquez.
She feels her experience with each of the rotations helped to shape her into a better counselor. “I got the chance to work with such great dietitians during this experience and have taken bits and pieces from each of their philosophies of practice to help shape my own,” said Enriquez.
One thing Enriquez, a Texas A&M University graduate, learned during the internship was that life isn’t always by the book. “There might be a ‘right answer’ but it isn’t always best for everyone,” said Enriquez.
The Texas WIC Dietetic Internship helped Vanessa Patterson see her community in a whole new light.
“I found opportunity to continue to help my community after the internship is over and more avenues to continue the nutrition education,” said Patterson.
She learned that registered dietitian jobs go beyond the classroom; they are educators, administrators, representatives, and ambassadors of nutrition.
“This experience is priceless; you go through the Food Service, to a hospital adult and pediatric and finally completions in community where everything you learn comes to practice,” said Patterson, a graduate of Texas State University in San Marcos.
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2011 Interns Share Expectations and their goals
The 2011 interns began their internship in January. Here is what they had to say about their expectations and goals. In their own words...
Anissa Miller - “I want to use this knowledge to help the children and parents at our WIC clinics make healthier choices and hopefully live healthier lives because of it.”
Bethany Romero - “I have always felt that something so basic as the food we eat holds the key to preventing many, many diseases and chronic illnesses. …the WIC Dietetic Internship has been a long-time goal of mine.”
Brittney Nicole Adams - “ …The WIC Dietetic Internship is a wonderful opportunity and I feel extremely privileged to be a part of it.”
Cassandra Shockey-Holguin - “I want to become a registered dietitian and continue my work with WIC. To do this, I need to gain knowledge and insight from experienced professionals in the field.”
Corinna Orms - “Since working for UTMB-WIC, I have developed a passion for pediatric nutrition. After attaining my RD licensure, I next plan to work on becoming certified as a Pediatric Specialist and IBCLC.”
Gladys Rodriguez - “I am thrilled in having the opportunity to be part of the Class of 2011 Texas WIC Dietetic Internship! … I enjoy being part of WIC which is truly helping grow healthy families!”
Enrique Lira - “I believe the internship will not only allow me to make a difference, but be the difference.”
Meagan Williams - “The Texas WIC internship is an amazing opportunity to further my education to become a Dietitian.”
Melissa Gause - “I arrived at the decision to become a dietitian several years back because it has always been ingrained in my way of life that prevention is truly the key to health and longevity.”
Meredith Spencer - “I am intrigued by the new frontiers being explored in nutrition and the completion of my internship will allow me to play a larger role in communicating a positive nutrition message to the public.”
Rachel Dunn - “The reason I want to do the internship: To further my knowledge of nutrition, and to be able to provide high risk counseling at my clinic.”
Stacy Guzman - “I want to do the WIC internship because it best suits my learning interests and because I want to be able to better assist my community.”
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Corpus Christi Hospital Helps Local Agency Host Health Fair
by Renee Mims
What do Sesame Street cookbooks, a hula hoop contest, and Zumba lessons have in common? Why WIC-A-PALOOZA of course!
More than 300 attended the event, which was sponsored by the Driscoll Children’s Hospital in Corpus Christi, the Obesity Prevention Mini-Grant Project in the summer of 2010 and WIC Local Agency 5.
“The intent of the event was to bring health and fitness awareness to WIC participants and community members,” said Carmen Goodwin, LA 5, WIC nutrition coordinator and clinic supervisor. “The support we received from the more than 20 community agencies made for a successful event.”
Some of the agencies were American Diabetes Association, Avance, Driscoll Children’s Hospital Industry Prevention Program, Early Child Intervention, Expanded Nutrition Education Program, Food Bank Healthy Families Program, Metro Ministries, Nueces County Community Action Agency, University of Texas Community Outreach Program, YWCA, and Zu Can Do It Fitness (Zumba).
The event featured cooking demonstrations using whole grains, fruits and vegetables, and low-fat milk. Children participated in a hands-on nutrition activity by making fruit kabobs. To encourage at-home healthy eating/cooking WIC clients were given Sesame Street cookbooks.
“Obesity has become an epidemic in our country,” Goodwin said. “This is just one more way that we can pass along helpful information to make our community a healthier one.”
Fitness activities included a hula hoop contest and Zumba—a dance-exercise program that uses a fusion of Latin and International music.
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WIC Wellness Works: Get Fi$cally Fit (and Have Fun) in the New Year
Sometimes, the very best ideas for making improvements that decrease our stress and build our quality of life can be found right in our own community.
Last January, the WIC Wellness Works program offered WIC staff the Simple Steps to Financial Wellness packet—a starter kit on saving, swapping, and smart spending. WIC clinics from across the state came up with some great ideas for stretching their dollar.
Here’s how a few agencies worked together to gain valuable tips, save money, and have fun! See “What Fi$cal Fitness Activity Can You Kick-Start at Your Worksite?” on page WIC Wellness Works – 4 to learn how you can too!
Project 94, Midland-Odessa
Project 94 held a Media Swap where staff brought books, magazines, DVDs, and CDs to an agency meeting. All leftover items were donated to the county library. WIC Wellness Works (WWW) Coordinator Virginia May shared, “It was fun learning what types of books and magazines people read. It was such a success that we plan to do it again in December.” What a creative way to exchange gifts among co-workers!
Project 77, Galveston
Agency 77 held a Swap trading DVDs, jewelry, board games, recipes, and decorative items. They also created a clinic Budget Board. “The bulletin boards had flyers advertising specials on services and products, coupons, areas for staff members to write money-saving tips, and websites offering great deals,” said WWW Coordinator Tamara Lewis.
Local Agency 54, Fort Worth
WWW Coordinator Laurie Arrington hosted a Coupon Exchange within her agency, “Our clinic brought in coupons on a weekly basis and let everyone pick from them. That was the most I have ever saved with coupons in a month! Our nutritionist saved $85 with coupons in one grocery shopping experience.”
Local Agency 76, Vernon
Barbara O’Neal joined with other WWW Coordinators Ann Latham, Gloria Castro, and Bonnye Warminksi to host a Swap Till You Drop event at their agency. Barbara reported, “Staff was asked to bring a gently-used purse and a kitchen item. It was a great hit. Every clinic also posted a Super Savings Board to share great ideas on how to cut costs. Many of the boards had clipped coupons for anyone to take.”
Local Agency 88, Corpus Christi
The staff at LA 88-01 held a Salad Swap. Everyone brought a favorite recipe that was delicious, simple, healthy, and easy on the pocket book. WWW Coordinator Hattie McKnight combined the recipes in a cookbook that each staff member got to take home. Think of the money they’re saving making their own tasty homemade food instead of going out to eat!
Local Agency 87, Tyler
WWW Coordinator Beth Lloyd shared, “We held a DVD Swap and Shop during our kick off for financial wellness. About 90% of the staff brought a DVD that they no longer watch. There was something for everyone. It was a high energy kickoff and we learned a little about our coworkers too.”
WIC State Office, Austin
Wellness Coordinator Tiffany Brown and her colleagues held a Financial Tip Swap where they shared their best financial advice at a “Go Green” St Patrick’s Day potluck. Staff brought in a green fruit or veggie and made smoothies to sip while they shared ways to eat green and save green!
What can your agency do to kick off some fiscal fitness fun in 2011? Hold a swap? Create a savings board? Form a coupon club? Our economic times may be challenging, but right here in our communities—we are rich with opportunities to learn, save, and enjoy the company of our coworkers. And you can’t put a price on that!
What Fi$Cal Fitness Activity Can You Kick-Start at Your Worksite?
Build a budget board!
Using a clinic bulletin board, encourage staff to post weekly sales flyers for local stores, coupons, contact information for affordable services (automotive, hair styling, etc.), sticky notes with financial tips (helpful websites, etc.), printed lists of local money savers (restaurants with “kids eat free” nights, museums with free entry), upcoming free or low-cost events (festivals, performances), and so on. By locating the budget board near your waiting room, your WIC clients can benefit too!
Start a Coupon Club!
Using a binder with clear sleeves or an accordion file, ask staff to bring coupons and file them by category (frozen, dairy). Leave the file in your break room for easy access. Encourage staff to look for coupons with healthy choices. This can sometimes be difficult since many coupons are for processed foods – but here’s a tip: many stores offer in-house coupons that can be used on items like produce and seafood. Consider exchanging these in your coupon club and double your value – healthy food at a lower cost!
Host a Swap ‘n Shop!
Holding a swap is easier than you might think. With your colleagues, choose a time and location to hold the event. Then decide upon a theme—try to choose something specific. Some of the agencies who held a WWW swap exchanged exercise videos, cooking tools, and clothing. Put all the items in an easy access location and give “shoppers” time to make selections. Leftover items can be donated to a charitable cause.
Taking the Walk the World with WIC Challenge to New Heights
Barbara Khaleeq, LA 20 WIC director, couldn’t hide her enthusiasm for the WIC Wellness Works Challenge — Walk the World with WIC. “This was fun! We have participated in all of the physical activity challenges and while they have all been fun, the staff really enjoyed this one.” LA 20 decided to ramp up the excitement of this challenge by taking it to the next level — they challenged two of their umbrella agency’s offices to see who could accumulate the most walking minutes.
“Regence Health Network (RHN) is our parent agency and Barbara thought it would be fun to bring them into the challenge,” said Ginny Rawls, I.B.C.L.C., the breastfeeding coordinator and WIC Wellness Works agency coordinator. “We challenged the RHN administrative office as well as the dental and medical office staff. This is definitely what sparked everyone’s enthusiasm. The competition with our co-workers was the key — the one-on-one competitiveness really spurred us on. A lot of people had stopped exercising and this provided motivation to begin,” said Barbara.
Ginny and Barbara said that each group had 13 to14 participants, and they kept track of their minutes on a spreadsheet, which was passed around to each office every week. The Walk the World with WIC competition kicked into high gear after the first week when the RHN administrative office turned in the highest number of accumulated minutes. “Everyone got serious at that point,” said Rawls.
Both Barbara and Ginny agreed that there has to be support from top administration to successfully implement a wellness program. “The WIC director has to allow the time and has to encourage the staff to get involved and have fun,” said Barbara. “There has to be some flexibility too.”
“Barb was very encouraging and allowed us to take walking breaks in twos, as long as the clinic was adequately staffed,” said Ginny. “We buddied up and it worked really well. Some staff would come in early and others stayed after work to exercise with the video. The video was difficult at first but we stuck with it and felt we had really accomplished something when we got through it.”
Ginny added, “We would cheer at the end because we could stay with it.”
“The staff really liked that they could count 10-minute increments,” said Barbara. “Ten minutes was something they thought they could do.” Barbara shared that she came across staff walking in place while watching the WIC civil rights and customer service IDL training in order to get in more minutes — that’s motivation!
LA 20 held a kickoff at the beginning of Walk the World with WIC which included a WIC group walk. They held monthly meetings with ethnic snacks, and at the end — they held a potluck lunch in which everyone was assigned an ethnic dish to bring. They later got together with Regence and held a celebration meeting to announce the winners. All staff who joined in received a cookbook for participating. To top it all off, the WIC office won the intra-agency challenge and was a third place winner in the Walk the World with WIC Global competition. The challenge was so successful that the RHN administrative staff issued a follow-up challenge in order to redeem themselves. The Plainview WIC office plans to work hard to maintain their first place status. Good luck, LA 20 — you have definitely taken WIC Wellness to new heights!
Chocolate- & Biscotti-Dipped Strawberries
A crunchy coating of biscotti lends taste and texture to this Valentine favorite.
From EatingWell: May/June 1997, The Essential EatingWell Cookbook (2004)
About 24 pieces | Active Time: 20 minutes | Total Time: 20 minutes
1 large almond or hazelnut biscotti
4 ounces bittersweet chocolate, chopped
2 pints strawberries, washed and dried
Crush biscotti in a food processor or with a rolling pin. Melt chocolate over a pan of hot water. Holding on to the stem, dip each strawberry in chocolate to coat about half the strawberry, then dip into biscotti crumbs. Place on a wire rack until chocolate has hardened.
Per piece : 28 Calories; 2 g Fat; 1 g Sat; 0 g Mono; 0 mg Cholesterol; 4 g Carbohydrates; 0 g Protein; 1 g Fiber; 3 mg Sodium; 18 mg Potassium
Exchanges: 1/2 fat
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Interactive Voice Response System Available 24 Hours
by Rachel Edwards
Manager, Information Response Management Group
With more than one million participants receiving benefits on a monthly basis, the 1-800-WIC-FORU line stays very active receiving calls ranging from inquiries on WIC clinic locations to callers reporting lost or stolen WIC EBT cards.
In March 2010, Texas WIC implemented an interactive voice response (IVR) application that allows callers to the 1-800-WIC-FORU line to respond to prompts by using their telephone dial pads or by speaking directly to the system, which uses text-to-speech and speech-recognition technology. The application provides automated responses in English and Spanish to the most frequently asked questions, allowing phone operators to direct their efforts to more complex tasks. Calls to the 1-800-WIC-FORU line are answered by eight phone operators in the Information Response Management Group.
The IVR system is available 24 hours a day, seven days a week, so callers can get answers to many of their questions after normal business hours. The IVR system provides automated responses to routine inquiries such as WIC clinic locations, general eligibility information, and helpful toll-free numbers to other programs. Any caller who needs further assistance can choose to speak with an operator between 8 a.m. and 5 p.m., Monday through Saturday.
Although the 1-800 line operators respond to over 20,000 calls per month, the IVR system is able to provide automated information to an additional 20,000 calls within normal business hours and after hours.
Below are the menu options for the 1-800-WIC-FORU line available in English and Spanish.
• To find out if you are eligible to get WIC benefits, press or say “one”
• To find the location of the WIC clinic closest to you, press or say “two”
• To report a lost or stolen WIC EBT card, press or say “three”
• To learn about the WIC program and some helpful toll-free numbers, press or say “four”
• To repeat this menu, press the pound key or say “repeat”
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WIC Needs a True Representation of Household Income
by Megan Downing
At the state office, we understand how busy your WIC clinics can get, and we all do our best to get our clients the best service possible. There are questions that the Information Response Management (IRM) liaisons respond to more often than others. Below are two of those common questions and answers.
Q. It seems like we are seeing many more applicants and participants who are recently unemployed. How do we handle these situations? Should we use their last paycheck stub?
A. If an applicant or client comes into your clinic with a paycheck stub from their last job, and he or she is currently unemployed, we are not able to accept that paycheck stub as proof of income because the applicant or client is not earning anything, and we need a true representation of household income. We need to find out how that applicant or client is surviving and paying bills. Written documentation of all current alternate income such as child support or severance pay should be requested. If a friend or relative is providing support, that person should complete a WIC-19a or furnish a statement of the amount of support provided. Applicants or clients may also be living off a checking or savings account. In this case, obtain a copy of the checking or savings account statement and find out what the client is withdrawing on a monthly basis to pay bills or expenses. The withdrawals plus any interest is considered monthly gross income. The interest can often be found on the statement or we can take a verbal declaration from the client. If the applicant or client is living off of cash on hand, he or she can declare a monthly “amount of cash used” with a signed statement.
Q. It is easier to put a client on the program when they are on one of the gateway programs, Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF) or Medicaid. Sometimes the gateway programs are confusing. How do we know we are handling the adjunctive income eligibility correctly?
A. Adjunctive income eligibility is intended to expedite income eligibility for individuals and certain household members who have documented participation in the SNAP, TANF, or Medicaid Program. SNAP, TANF and Medicaid are referred to as gateway programs and are often a convenient way for clients to meet income eligibility.
Current and acceptable documentation of TANF benefits would not only make the person receiving benefits adjunctively income eligible, but also anybody living in the household with the person receiving TANF would be adjunctively income eligible. The people in the household do not have to be related.
Example: Sarah and Lisa live in the same house together to save money on rent. Sarah is receiving TANF. Lisa is pregnant but is not receiving any assistance and wants to apply for the WIC program. Lisa can bring current proof of Sarah’s TANF and proof that she shares a household with Sarah to meet income eligibility for WIC.
SNAP benefits may be received by one individual in a household or several individuals in a household. Only the person or persons who are eligible to receive SNAP benefits are adjunctively income eligible for the WIC program. Most SNAP forms are issued in the name of the head of the household, although other unnamed members of the household may also be receiving benefits. Verbally verify which members of the household actually receive SNAP benefits with the head of household so they can be adjunctively income eligible for WIC.
Example: Mary Smith has an acceptable, current SNAP documentation listing her as the head of household. There are no other people listed on the form. You will ask Ms. Smith who in the household is receiving SNAP benefits and document her response.
An applicant or participant receiving current Medicaid benefits would be adjunctively income eligible for the WIC program. If a pregnant woman or an infant is receiving current Medicaid benefits, anybody living in that household would be adjunctively income eligible for WIC. The people in the household do not have to be related. A pregnant woman’s Medicaid eligibility ends the last day of the second month after the pregnancy has ended. At this time, the infant should receive their own Medicaid.
Example: Joan and Linda live in the same household but are not related. Joan has a 2-year-old and is not on the WIC program but would like to apply since she is not receiving any other assistance. Linda was on Medicaid while pregnant, but just had her baby 3 weeks ago. Linda’s baby is adjunctively income eligible because Linda was getting Medicaid while pregnant and the baby was delivered less than 2 months ago. Linda’s infant makes Joan’s 2-year-old adjunctively income eligible for a certification period because they live in the same household. As long as the infant has current Medicaid, the entire household will qualify.
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Local Agency Directors Reflect on the WCS Training Program
by The University of Texas at Austin WIC Certification Specialist (WCS) Group
In October 2010, local agencies started submitting applications for the WIC Certification Specialist (WCS) Certification and Training Program. The WCS Certification and Training Program is a newly developed standardized competency-based training.
Several clinics participated in pilot programs designed to test the training materials’ effectiveness. Through these pilot programs, 19 candidates received their WCS certification.
When talking about the benefits to the clinics, WIC Director Nora Martinez (LA #13 Laredo Health Department) said, “It helps with the efficiency of operations. As WCSs are trained in everything and can do everything all at once. They can certify, sign off and do counseling. They are kind of like a one stop shop.”
WIC Director Barbara Khaleeq (LA #20 Regence Health Network, Inc., in Plainview) agreed stating, it feels like “a burden has been lifted from the staff members that certify, because the WCS can help with that.”
The WIC certification specialist also benefits the WIC participant, as Kay Jarrett—WIC director (LA #32 Brazos Valley Community Action Agency in Bryan) BVCAA-WIC—points out, “Sometimes the participant has a greater sense of rapport with a new WCS, because they were the clerks the clients have worked with before. They already feel a bond with the clerks, kind of like visiting a friend.”
Not only do clinics and participants see benefits from the WCS Certification and Training Program, but so do the WIC staff that complete the training.
“They feel more important at their job, and that they are really needed. They have gained a feeling that they are needed in the clinic and they are relied upon more than the past,” said Khaleeq.
Jarrett added, “The candidates have a greater feeling of self-confidence and self-worth. The ones who have gone through the training are assuming more of a leadership role. It created a greater appreciation of the other staff’s jobs, and they have a better understanding of the entire process.”
The WCS Certification and Training Program consists of 12 self-paced modules. The modules provide candidates the opportunity to build skills in rapport building, effective communication, anthropometric and biochemical data collection, program delivery, ethics and professionalism. The training includes learning activities, such as case studies, hands-on activities, self-checks and module reviews. These along with participant observations are intended to help the candidates learn new material, refresh in learned material, assess their own progress and practice their skills.
“I thought it was a very good training program, it was something the staff could do at their own pace. I liked that there was feedback and learning throughout the training. The training material was very helpful,” Khaleeq said.
Jarrett agreed, but also added that the training is relevant to everyday clinic activities. “It was an extremely good training program that created good experiences for the candidates. The training was well thought out and very useful. Everything in the training was something they could use in the clinic and they [the candidates] felt like they could use it.”
The training program was built from current WCS training programs, national best practices and incorporates value enhanced nutrition assessment (VENA) practices. The standardized WCS program is intended to improve the quality and scope of WIC services, improve clinical skills, create better clinic flow, and enhance the WIC participants’ experiences.
“The WCS training has worked for many years, the difference between now and then is that the state now has the curriculum in place to ensure consistency,” said Martinez.
Standardizing the training also decreases the workload of registered dietitians, allowing clinics to better assist high-risk clients.
In addition to helping improve overall clinic operations, standardized training provides clinic employees flexibility within the clinic.
“We do a lot of cross training, and this has been fantastic. This allows us a lot more flexibility within the clinic, in terms of positions, and gives them more responsibility,” said Jarrett.
The training program allows WIC certification specialists the opportunity to work as a WCS even if they change locations within Texas.
“One of the benefits is that staff across the state will be doing the same thing. It is wonderful they are giving certificates that can be transferred. They can walk right in to another clinic and say they are a WCS, which makes them more marketable across the state,” said Khaleeq.
Jarrett reinforced this point saying “I love to hire people that have already worked for WIC, and it would be a
benefit if they already had the WCS certification. It cuts down on the training needed.”
The WCS Certification and Training Program can also help move WIC staff up the career ladder.
“It has put a level of advancement that the clerical staff can achieve by working and going through this training. It provides an opportunity to clerical staff that was not there before,” said Khaleeq.
Jarrett supports this claim saying, “It gives clerks an opportunity for upward mobility.”
The WCS Certification and Training Program requires some planning. Local agencies should start preparation at least three months in advance and be aware that the program takes anywhere from three to nine months. Local agencies should schedule additional time for their first set of candidates, since directors, preceptors and candidates will need to become familiar with the material and required time commitment.
Since every clinic is unique, they should develop their own implementation process, using suggestions and best practices that emerged from the pilot programs.
According to Martinez, to properly implement the training program directors need to buy into the program, show support, plan ahead of time, and provide candidates ample time to study.
“Clinics need to provide at least one hour a day to concentrate on the reading. We allotted the first hour of the day for reading and assignments, and then had weekly preceptors’ meetings. This kept the motivation going,” said Martinez.
Khaleeq agreed stating, “Before they [clinics] begin, they need to be prepared to give staff time to work on the modules, and figure out a system. They need to be flexible with the process until they figure out what works best.”
For information about the WCS Certification and Training Program and to request an application contact Tonia Swartz, R.D., L.D., WIC Clinical Nutrition Specialist at Texas WIC—1-512-341-4586 or firstname.lastname@example.org.
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state agency spotlight - Angela Gil: Career Path Includes the Texas WIC Dietetic Internship
by Angela Gil, R.D.
Nutrition Education Consultant
My career path to becoming a dietitian was not the quickest or the most conventional. When I first heard of the Texas WIC Dietetic Internship, I was excited. It sounded like the perfect opportunity for someone like me. I had several years of WIC experience and was not sure how I could get into an internship without leaving my job, and still be able to support my family. I was finally accepted to the class of 2007 while working for LA 41(San Antonio Metropolitan Health District).
The internship was demanding to say the least. Assignments were due every week, and I stayed up late many nights finishing work. The internship quickly taught me how to have effective time management skills and be proactive. One aspect about the internship that I didn’t anticipate was the networking opportunities that arose with my different preceptors. I quickly realized that not only was I representing Texas WIC, but I could possibly be working with these registered dietitians in the future, whether it was with ECI and coordinating nutrition care for a high risk WIC child or collaborating with other dietitians on special projects for the City of San Antonio. The internship forced me to get out of my comfort zone and experience things that I might otherwise not have experienced, such as conducting nutrition presentations to senior citizens or presenting complicated case studies to dietitians and doctors.
I was exposed to many different areas of dietetics such as foodservice, community, clinical and pediatric dietetics. While all the fields are important and serve an important purpose, I was drawn to community and public health nutrition where the primary focus was prevention and promotion of nutrition and wellness in the community. This helped me realize that working for WIC was the perfect fit for me.
After successfully completing the internship, I returned to LA 41 to supervise a clinic. Even though it was a little hard to get back into the swing of things, I had a new enthusiasm for work and counseling families. I was able to provide the in-depth counseling that I couldn’t before and was able to help families make long-term behavior changes with the new techniques that I have learned. Overall, I was better equipped to serve my community and their nutrition needs.
The skills and knowledge I acquired help tremendously in passing the registered dietitian exam in February 2008. I was then able to move into the quality assurance registered dietitian position at my local agency and also take over the Obesity Prevention Mini Grant. Duties ranged anywhere from assuring new policies were being implemented, conducting clinic audits and interviews to teaching cooking classes, conducting value enhanced nutrition assessment (VENA) training and participating in the city’s other obesity prevention initiatives.
My decision to apply for and accept a position with WIC at the state level stems from the fact that there are many wonderful changes coming in the future with Texas WIC. It is an exciting time and I wanted to be a part of those changes and contribute to the development and growth at the state level. From day one here at the state, my observation is this: the staff truly believes in the WIC program and the help that we provide for our families. I am proud to say that I am part of the WIC family.
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state agency spotlight - Paula Kanter: Receives TALWD Award
by Renee Mims
Paula Kanter, nutrition specialist in the Clinic Services Branch, was awarded the 2010 TALWD Award for excellence in the workplace by the Texas Association of Local WIC Directors. Kanter was recognized for her leadership and service to the Texas WIC local agencies.
The award is conferred annually to a staff person in the DSHS nutrition section who demonstrates pride and excellence in WIC expertise.
Kanter, who has been with DSHS for more than 13 years, was completely surprised when her name was called at the meeting on October 20 in Tyler.
“When they presented the award, it sounded like they were describing Ellen Larkin.” said Kanter. “When they said my name, I threw my dinner napkin across the table at her because she knew all along.”
The nomination announcement included statements about her from local agencies:
• “She works diligently to make sure the locals have the current list of approved foods and that we know what is going on with the multitude of deliberations in approving new foods...”
• “She is quick to respond to requests or questions that the locals have...”
• “She is friendly and polite and professional...”
• “She listens to the local perspective and tries to represent the local interest when making decisions that will impact us...”
Kanter’s state office colleagues express their thoughts on her work:
“Paula Kanter is one of the hardest working, most productive individuals in WIC. She has an incredible workload and yet always finds time to cover someone on formula beeper, help proof or edit her peer’s work, attend and contribute in meetings and serve as a resource for everyone. She volunteers to assist whenever anyone needs help. It has become a standing practice for her peers to try and protect her from taking on too much workload, and to compare her work ethic and practices as the epitome of excellence.” Patti Fitch
“Paula is an incredible woman! She is always willing and ready to give a helping hand, even though she has her own workload. She keeps up the latest WIC information and makes sure we are aware of it. She provides excellent customer service to everyone she deals with, local, state and vendor staff. If you want to feel good, hang out with Paula for a day!” Anita Ramos
“Paula is a true asset to the Texas WIC program. It is not uncommon for her to go above and beyond what is required to best meet the needs of both Texas WIC staff and participants.” Shirley Ellis
“Paula has an incredible memory … her knowledge about WIC, especially policy, is absolutely amazing! She’s always willing to help and is super friendly and considerate of others … she’s a real asset to our team.” Tiffany Brown
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test your nutrition IQ
by Eaton Wright, BS, NUT
Eaton here with a brand new Nutrition I.Q. quiz for a brand new year. New year means it’s a good time to try new things. And this year, my goal is to try one new and unfamiliar fruit and vegetable every month of 2011. This time around let’s get to know fruits and vegetables just a little bit better.
1. Which fruit is not a drupe?
2. True or False – September is national rutabaga month.
3. Which of the following is not a vegetable?
a. Brussels sprout
b. Vegetable brain
4. What fruit is on your ‘must try’ list?
e. Star fruit
f. All of the above
1. Not trying to slip you up on this one but the answer is D, banana. A drupe is a fruit with an outer fleshy skin that surrounds a hard stone seed inside. I know you’re itching to read this — mango belongs to the Anachardiaceae family. Distant relatives include poison ivy and poison oak.
2. The answer is true. Derived from the Swedish word rotabagge, meaning ‘round root,’ rutabaga is a good source of dietary fiber, thiamin, vitamin B6, calcium, magnesium and phosphorus, and a very good source of vitamin C, potassium and manganese. Take it from Eaton, get a rutabaga and treat your family to a taste sensation.
3. This one is a no brainer. The answer is B, vegetable brain. Vegetable brain, or ackee as it is better known, is the national fruit of Jamaica. The seeds of the ackee are toxic and must be removed before the fruit is eaten. Captain William Bligh (of Mutiny on the Bounty fame) brought ackee to England from Jamaica. Because of this, the scientific name of the ackee is derived from his name—Blighia Sapida.
4. I hope your answer is F, all of the above. While relatively unknown in the United States, each one of these fruits is a “star” fruit in its native country. Take cherimoya, for instance. Originating from the Andean-region of South America, the flavor has been described as a blend of banana, pineapple, papaya, peach, and strawberry. In fact, Mark Twain said the cherimoya is “deliciousness itself.” I don’t want to overstate the cherimoya, but it sounds like the best fruit few of us have ever tasted.
About the author: Eaton Wright is a certified NUT based in Austin, Texas.
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