Nevada WIC Program-General Program AdministrationPage 1 of 10
Introduction
Provided is the template for the Local Agency Nutrition Services Plan (LANSP) for October 1st, 2016 through September 30, 2017. The State Agency uses this plan to identify priorities for nutrition education, breastfeeding support, outreach activities, and staff training for each fiscal year consistent with State and Federal regulations [Regulatory Citation: 7CFR 246.4 (a) (9)], and also provides local agencies with a tool for self-assessment and future program planning.
The LANSP is a continuous process of assessment, implementing strategies, and evaluating results. The Local Agency Nutrition Services Plan Process is shown graphically below. It is important that agencies take the time regularly to assess their needs and work toward improvement. The LANSP provides one tool to accomplish this task.
Please follow the instructions from the LANSP Review Guidance for submission of your Local Agency Nutrition Services Plan. Plans are due electronically and in specified format by August 15th, 2016.
Local Agency Nutrition Services Plans are due to the State Office no later thanAugust 15th, 2016. Plans must be submitted electronically and in the format detailed below. Failure to submit the LANSP by the due date may result in a delay of reimbursement.
Overview of Required Components:
- Evaluation of FY 2015-16 goals
- Needs Assessment Worksheet
- Goals and Objectives: Minimum of 2 measurable goals in any of the following areas: (1) Nutrition BreastfeedingEducation (2) Breastfeeding Support(3) Clinic Environment & Customer Service and (4) Individual Agency-Specific
- Training Plan
- Outreach Plan
- Local Agency Contacts / Employee Roster
- Evaluation of FFY 2015-16 Goals
Review and evaluate the goals and objectives submitted in last year’s FY 2016Local Agency Program Plan. Use the forms below to provide a written assessment of your progress in achieving these goals and objectives.
Goal #1Please state goal
Was the goal achieved? Yes No
Summarize data to support your claim and enter here. (Do not send copies of data forms or reports.)
Add response
Did you encounter any problems or obstacles? Yes No
If yes, please describe here.
Add response here
Were the objectives realistic in terms of your agency’s resources, needs and time frame?
Yes No
If no, please explain here.
Add response here
Were your action steps and evaluation methods practical for your agency’s resources, needs and time?
Yes No
If no, please explain here.
Add response here
For each action step, provide the following information:
Did you complete it? Was it a successful action step? Will you continue to implement this action step?
Add response here
Was a short-term or periodic evaluation completed?
Yes No
If yes, how did this information change your action plan in the past year? How will it impact your plans for next year?
If no, why not?
Add response here
Goal #2
Please state goal
Was the goal achieved? Yes No
Summarize data to support your claim and enter here. (Do not send copies of data forms or reports.)
Add response
Did you encounter any problems or obstacles? Yes No
If yes, please describe here.
Add response here
Were the objectives realistic in terms of your agency’s resources, needs and time frame?
Yes No
If no, please explain here.
Add response here
Were your action steps and evaluation methods practical for your agency’s resources, needs and time?
Yes No
If no, please explain here.
Add response here
For each action step, provide the following information:
Did you complete it? Was it a successful action step? Will you continue to implement this action step?
Add response here
Was a short-term or periodic evaluation completed?
Yes No
If yes, how did this information change your action plan in the past year? How will it impact your plans for next year?
If no, why not?
Add response here
- Local Agency Goals & Objectives
- Needs Assessment Worksheet
Evaluate your agency’s current practices in the areas of (1) nutrition andbreastfeeding education (2) breastfeeding support, and (3) clinic environment and customer service. Provide feedback regarding how practices in these areas could be improved and what resources, if any, would be needed to make the improvements.
Nutrition and Breastfeeding EducationCheck which of the following methods your clinic offer to provide follow-up (low risk) nutrition and breastfeeding education to participants:
_____ Individual one-on-one nutrition counseling sessions
_____ Family-based counseling sessions (addressing each participant’s needs in a family)
_____ wichealth.org online classes
_____ Group classes
_____Demonstrations/cooking classes
_____ Other, please describe:
Add response here
How is your agency addressing the unique nutrition needs of every WIC participant in a family before issuing benefits? (i.e. families with multiple participant categories)
Add response here
How does your clinic determine what topics will be available in low risk follow-up education offerings?
Add response here
Is participant input solicited? Yes_____ No_____
How could the topics be chosen to better meet the needs of your participants?
Add response here
IF group classes are utilized, in what format are they taught (i.e. structured class, support group or group discussion etc.)?
Add response here
How is the group classroom organized? (e.g. around a table, in rows, in circle etc.)
Add response here
Do you utilize visual models during lesson(s) (e.g. food models, food labels, breastfeeding materials / supplies, videos)?
Add response here
Have all your agencies nutrition and breastfeeding lesson plans been approved by the State Office?
Yes_____ No_____
If no, please submit your unique lesson plans to the State office.
How does your agency ensure VENA is being followed? (e.g. a complete nutrition assessment has been completed prior to delivering nutrition and breastfeeding education)
Add response here
How are you ensuring participant centered services (PCS) are used during nutrition and breastfeeding education? (e.g. using open ended questions, affirmations, reflections, summarizations)
Add response
Does effective utilization of PCS improve staff’s interactions with clients? How?
Add response here
How are participants being informed of what follow-up nutrition and breastfeeding education will be needed?
Add response here
How can this process be improved?
Add response here
How does your agency market and promote your nutrition and breastfeeding education offerings to participants?
Add response here
How can this be improved?
Add response here
What written materials or trainings will make yournutrition and breastfeeding education efforts more effective?
Add response here
Describe when WIC staff uses “next steps” on the Nutrition Documentation Form to assist in nutrition and breastfeeding education and counseling?
Add response here
Do you or your staff follow up with the participant’s progress of participantgoals at subsequent WIC visits?
Add response here
What special nutrition and breastfeeding education events or Quality Improvement (QI) steps (ways to improve your nutrition and BF services) have you done in the past fiscal year?
Provide summary of events or QI stepstaken here
What event or QI will be offered / performedin the coming year? Yes_____ No_____
If yes, please describe the planned event(s) / training(s) /improvement(s) .
Add response here
What additional information should we know about your nutrition and breastfeeding education activities?
Add response here
Breastfeeding Support
Each agency is required to designate a Breastfeeding Coordinator. Describe how this person helps all WIC staff promote breastfeeding in the WIC clinic.
Add response here
Does your agencytrack either agency or individual clinic breastfeeding rates?
Yes No
If yes, please describe your tracking method.
Add response here
If no, what perceived barriers prevent your agency from tracking breastfeeding rates?
Add response here
Describe how your staff promotes breastfeeding to pregnant women in your agency? Be specific—what classes, bulletin boards, promotional materials, etc. are used in this endeavor?
Add response here
Are all clinic WIC staff performing breastfeeding support and encouragement?
Add response here
Do your CPA and nutritionist staff conduct a Breastfeeding Assessment when a breastfeeding participant requests supplemental formula?
Add response here
Has your agency developed a breastfeeding support group for breastfeeding mothers?
Yes No
If yes, describe your group and future changes for improvement.
Add response here
If no, what are the perceived barriers to beginning such a group?
Add response here
Do your clinic(s) have a lactation room for breastfeeding participants and staff?
Yes No
If yes, how can your clinic improve this area?
Add response here
If no, what would be needed to provide this benefit?
Add response here
Describe your agency’s plan for furthering the education of WIC employees regarding breastfeeding promotion, support and management.
Add response here
What additional information should we know about in regards toyour breastfeeding education and support activities?
Add response here
Clinic Environment & Customer Service
Describe any clinic changes during the past year or anticipated in the next year that affect WIC services. Examples include renovation of facilities, changes in participant scheduling, changes in staff duties, new employees, new sign to help clients locate the clinic more easily, etc..
Add response here
Describe the changes that may be needed in your services to accommodate these situations.
Add response here
Each agency must have a plan to accommodate those with limited English proficiency. Each agency/clinic should complete one of the two following options. If your agency/clinic has participants with limited English proficiency on a regular basis, what is your plan?
Add response here
If your agency/clinic has participants with limited English proficiency on an infrequent basis, what is your plan?
Add response here
Review your clinics application list for the past 30 days; assess the appointments scheduled outside processing standards.
What is the most commonly used reason for an appointment being out of processing standards?
Add response here
Is No Show Management regularly completed for each day with WIC appointments?
Yes No
If yes, describe your methods/tactics for managing no show rates.
Add response here
If no, what is your plan to remedy this?
Add response here
Describe your agency’s efforts to assure that your clinic is child and family friendly. Be specific about what steps you have taken.
Add response here
What additional resources would you need to improve your clinics environment?
Add response here
How does your clinic assure participant confidentiality during clinic visits?
Add response here
Does your agency solicit regular feedback on the quality of WIC services from participants?
Yes No
If yes, which methods do you use to collect this information?
Add response here
How do use this information? Follow-up with participants on customer service issues?
Add response here
What additional information should we know about your clinic environment and customer service activities?
Add response here
2. Program Goals and Objectives
Addresses those items identified in the needs assessment. What do you want to accomplish? Each local agency must have a minimum of (2) measurable nutrition service goals based on the result of the needs assessment. The goals should be realistic and measurable. Please use the format on the following page to state your Local Agency’s goals and objectives:
FFY 2016-17 Goals Objectives
Goal #1
Local Agency Goal #1 Topic:Add response hereDescription: Add response here
What will be measured: Add response here
Direction of Change: Add response here
Baseline Measurement: Add response here
Target Measurement: Add response here
Action Steps:
A minimum of 3 action steps included.
Each action step should be written with sufficient detail and depth to support your objective. / Person Responsible / Implementation Date or Date Range
Monitoring/Evaluation Plan: How will you monitor your progress on this goal? How often will the progress be evaluated? Add response here
Goal #2
Local Agency Goal #2 Topic:Add response hereDescription: Add response here
What will be measured: Add response here
Direction of Change: Add response here
Baseline Measurement: Add response here
Target Measurement: Add response here
Action Steps:
A minimum of 3 action steps included.
Each action step should be written with sufficient detail and depth to support your objective. / Person Responsible / Implementation Date or Date Range
Monitoring/Evaluation Plan: How will you monitor your progress on this goal? How often will the progress be evaluated? Add response here
- Training Plan
Describe in-service training which is planned for staff. Such training must include training in Nutrition and Breastfeeding Promotion and should include presentations from other health/social agencies. Focus areas should also include the six VENA Competency areas:
- Principles of life-cycle nutrition: Understands normal nutrition issues for pregnancy, lactation, the postpartum period, infancy, and early childhood.
- Nutrition assessment process: Understands the WIC nutrition assessment process including risk assignment and documentation.
- Anthropometric and hematological data collection: Understands the importance of using appropriate measurement techniques to collect anthropometric and hematological data.
- Communication: Knows how to develop rapport and foster open communication with participants and caretakers.
- Multicultural awareness: Understands how sociocultural issues (race, ethnicity, religion, group affiliation, socioeconomic status and world view) affect nutrition and health practices and nutrition-related health problems.
- Critical thinking: Knows how to synthesize and analyze data to draw appropriate conclusions.
A minimum of twelve hours of training per year should be provided (not including the State sponsored training).
General topics to be discussed / Person(s) giving training / Title of persons receiving training / Length of Training.
D. Outreach Plan
Program Outreach, Coordination & ReferralsDescribe what your agency is doing to reduce barriers to participation in the WIC program forthe low-income employed. Describe ways clinics will ensure services, such as extended clinic hours, appointment scheduling, etc.
Add response here
How could your agency improve upon these efforts?
Add response here
Describe your agency marketing strategy to promote WIC services to hard-to-reach groups (teen mothers, immigrants, migrants, foster care givers, homeless, etc.)
Add response here
How could your agency better promote WIC in your community?
Add response here
Describe your agency’s efforts to educate physicians and other health care providers in your community about WIC.
Add response here
How successful have these efforts been in fostering good relationships with the health care community?
Add response here.
Does your agency provide outreach on a quarterly basis?
Yes No
If No, explain with what frequency outreach is provided and why.
Add response here
What resources would make your clinics efforts at outreach and marketing WIC services more successful?
Add response here
Does your agency collaborate with other health and social service programs/organizations to help improve WIC service coordination?
Yes No
If yes, list the agencies.
Add response here
How often is your agency’s community resource list updated? ______
How could this list be improved to better meet your participant’s needs?
Add response here
What additional information should we know about your program coordination and referral activities?
Add response here
Local Agency Outreach Plan
Describe future activities planned to: (1)Notify potentially eligible persons of availability of WIC services(2) Reduce barriers to participation and (3) coordinate program operations with other health and social service programs. Such activities may include: news releases to media sources; outreach to minority organizations; outreach to organizations that serve high-priority persons (pregnant and breastfeeding women and infants); outreach to the homeless; and outreach to infants and children under the care of foster parents, protective services, or child welfare authorities including infants exposed to drugs prenatally. Additionally, the plan should address efforts to serve working participants. Refer to Policy OR: 1.
Activity / Responsible person / TimeframeE. Local Agency Contacts / Employee Roster
Which staff member(s) hold the following positions or certifications?
Position / Staff Member/Title / Clinic / Email/Phone NumberBreastfeeding Coordinator
Staff Trainer
Registered Dietitian/Nutritionist(s)
Certified Lactation Counselor(s)
Peer Counselor(s)
List all current WIC staff by their respective titles, clinic location, and years of service. If a position is currently vacant, indicate this on the list and the anticipated date of hire.
Staff Member / Position / Clinic / Years with Agency / Employment Status i.e. FT/PT / Hours per Week if <FTNevada WIC Program-General Program AdministrationPage 1 of 10