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Chapter Seven Participant and Staff Education

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					Chapter Seven
Participant and Staff Education
                                   Overview

Introduction      This chapter covers participant education and staff training.
                  Education is an integral part of the WIC Program. Beginning
                  October 1, 2009 the Arizona WIC Program will adopt a new food
                  list which will require extensive participant and staff education to
                  ensure successful implementation. Refer to Chapter 3 Food
                  Package-General and Chapter 4 Food Package-Formula for
                  details on the new food package. In addition to the new food
                  options, participants may be eligible to receive Cash Value
                  Vouchers (CVV)/Cash Value Food Instruments (FI) based on their
                  category. For all intents and purposes, the Arizona WIC Program
                  Policy and Procedure Manual refers to all coupons, vouchers,
                  checks, and electronic benefit transfers as food instruments,
                  except where noted otherwise.
In This Chapter   This chapter is divided into six sections and eight appendices
                  which detail program education, nutrition education for
                  participants, breastfeeding promotion, education for staff, and how
                  to report the cost of nutrition education.




ARIZONA WIC PROGRAM                                          ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL             7-1                 REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education


                               Overview
                              (Continued)


Contents                                                                  Page
                   Section                   Title
                                                                         Number
                              Program Education Requirements
                      A                                                    7-4
                              for Participants
                              Participant-Centered Nutrition
                      B                                                    7-6
                              Education for Participants

                      C       Nutrition Education Care Standards           7-11


                      D       High-Risk Nutritionist Consults              7-12

                              Education for Professional and
                      E                                                    7-16
                              Paraprofessional Staff

                      F       Nutrition Education Resources                7-20


                                                                Continued on Next Page




ARIZONA WIC PROGRAM                                      ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL          7-2                REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education

                               Overview
                              (Continued)


Contents                                                             Page
                    Section                  Title
                                                                    Number
                   Appendix
                              Nutrition Education Materials           7-24
                      A
                   Appendix   Professional and Paraprofessional
                                                                      7-27
                      B       Training Dates
                   Appendix
                              AIM Competencies                        7-40
                      C
                   Appendix
                              VENA Competencies                       7-47
                      D
                   Appendix   State Resource Catalog WIC Order
                                                                      7-89
                      E       Form
                   Appendix
                              Hemoglobin Cut-Off Values              7-101
                      F
                   Appendix   Arizona State Nutrition Education
                                                                     7-108
                      G       Care Standards
                   Appendix
                              WIC Workforce Position Definitions     7-186
                      H




ARIZONA WIC PROGRAM                                     ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL         7-3                REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education
                              Section A
            Program Education Requirements for Participants

Certification     1. At initial certification appointments, staff will provide the
                      following to the participants or their primary and secondary
                      authorized representatives :
                     a) An explanation of participant eligibility criteria including
                        income, residency, category, and nutritional risk.
                     b) An opportunity to read, or get an explanation of WIC Rights
                        and Obligations and WIC Rules and Regulations. Staff must
                        check for the client’s understanding of the Rights and
                        Obligations. These must be documented in the Follow-up /
                        Nutrition Education button in the Care Plan screen of the
                        AIM system (79, 57) Please refer to Chapter 2, Sections K &
                        M.
                     c) An opportunity to designate an authorized
                        representative(s). This is documented in the Follow-up /
                        Nutrition Education button in the Care Plan screen of the
                        AIM system (94). Please refer to Chapter 2, Section P.
                     d) An opportunity to designate a proxy. A proxy who picks up
                        food instruments for a participant will be given the same
                        explanation on WIC Rules and Regulations and how to use
                        the WIC FIs. Refer to Chapter 2 Section Q.
                     e) An explanation of WIC foods to be purchased, and the
                        proper use of cash value vouchers (CVV) and cash value
                        food instruments (FI) in a grocery store or farmers’ market.
                     f) Mandatory referrals to services such as immunizations,
                        lead screening, food stamps, TANF, AHCCCS, child
                        support enforcement, and local resources for substance
                        abuse treatment and counseling. This is documented in
                        the Follow-up / Nutrition Education button in the Care Plan
                        screen of the AIM system (51)
                  None of these services count as a nutrition education contact.

                                                                  Continued on Next Page




ARIZONA WIC PROGRAM                                          ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL             7-4                 REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education

                              Section A
            Program Education Requirements for Participants
                             (Continued)

Certification     2. At subsequent certification appointments, participants will be
(Continued)          given an opportunity to read or have explained the WIC Rights
                     and Obligations and WIC Rules and Regulations and referrals
                     to services. Staff must check for the client’s understanding of
                     the Rights and Obligations. In addition, staff will assess
                     participants’ understanding of WIC eligibility criteria, allowable
                     WIC foods, and the proper use of CVVs and FIs.
                     Documentation in the Follow-up / Nutrition Education button in
                     the Care Plan screen of the AIM system is required.




ARIZONA WIC PROGRAM                                          ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL             7-5                 REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education
                                Section B
         Participant-Centered Nutrition Education for Participants

Policy             Participant-Centered Education (PCE) is a framework of
                   providing nutrition services where the participant is the
                   decision maker in the educational process based on their
                   needs (risks, family situations) and interests. PCE nutrition
                   education will be offered to all WIC participants utilizing State
                   approved nutrition education care standards developed by the
                   Local Agency, Bureau of Nutrition and Physical Activity (BNP),
                   Arizona Department of Health Services (ADHS) or other
                   accepted nutrition authorities.
                   All participants will be offered the opportunity to receive two
                   PCE nutrition education contacts during a six month
                   certification as part of WIC Program service requirements. All
                   participants or caregivers of infants whose certification periods
                   are greater than six months will receive a PCE nutrition
                   education contact at least quarterly.
                   A nutrition education contact is defined as a verbal
                   communication between WIC staff and participants in an
                   individual or group setting. Nutrition education should be
                   designed to stress the relationship between proper nutrition
                   and good health based on the needs of the participant and
                   assist the participant in achieving a positive change in food
                   habits resulting in improved health. All nutrition education
                   activities are to be provided in the context of the participant’s
                   environmental and educational limitations, their interests, and
                   cultural preferences with consideration as to where the
                   participant is in the stages of change. The contact will include
                   the development of a nutrition care plan based on the nutrition
                   assessment results and participant interests and a discussion
                   of potential next steps for behavior change.
                   The environment where participants receive their WIC services
                   will be welcoming and promote learning and facilitate positive
                   messages related to nutrition, health, safety and civil rights.
                   However, individual participants shall not be denied
                   supplemental food benefits if they refuse to participate in
                   nutrition education activities.
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ARIZONA WIC PROGRAM                                          ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL              7-6                REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education

                              Section B
       Participant-Centered Nutrition Education for Participants
                             (Continued)

Individual          The nutrition education specialist will engage the participant
Education              in a discussion related to their nutrition assessment and
                       their interests.
                      After the topic has been discussed, the nutrition education
                       specialist will help the participant identify next steps or their
                       goals based on their readiness for change.
                    The nutrition education specialist will document nutrition
                       education in the Care Plan screen by clicking in the Follow-
                       Up/Nutrition Education button and selecting one or more
                       topics covered, from the ―List of Values‖ (LOV) button.
                    Nutrition education shall be documented for each individual
                       participant in their individual care plan. Topics which apply
                       to the whole family may be discussed, as long as the topic is
                       documented in each individual file.
                    A nutrition goal is set (or tailored in AIM), which reflects the
                       participant’s stated next steps or intentions based on their
                       readiness for change. Staff shall select 1-3 goals that reflect
                       the participant’s words and utilize the Notes button in the
                       Care Plan screen to document when appropriate.
Group             Participants may attend a facilitated group nutrition education
Education         session as a second nutrition education contact if determined
                  as appropriate by the WIC Certifier. Local Agencies will include
                  methods for evaluation in group class education plans/classes.
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ARIZONA WIC PROGRAM                                            ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL              7-7                  REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education

                                 Section B
          Participant-Centered Nutrition Education for Participants
                                (Continued)

Proxies             The WIC staff should determine at the time of the appointment
                    whether the proxy should receive nutrition education,
                    depending on their role in caring for the WIC participant.
                    Proxies should receive nutrition education for a participant when
                    the proxy is a member of the participant’s household or a
                    caretaker of a child or infant participant. (A caretaker could be
                    a regular day care provider, parent, grandparent or other
                    relative). This makes the participant eligible to receive their FIs
                    and CVVs.
                    Note: Friends, neighbors or relatives who do not ordinarily care
                    for a participant or live with them may pick up food instruments
                    for the participant, but will not need to receive nutrition
                    education and may only receive one month of FIs and CVVs
                    may be issued. The Authorized Representative will receive
                    nutrition education at their next pick-up.
Monitoring of       During Management Evaluations (M.E.) or other site visits, the
Nutrition           State Agency staff will monitor nutrition education to determine
Education           if:
                      Information provided is accurate and up-to-date
                      Information is individualized to meet participant’s needs and
                       interests, considering the educational level, lifestyle and
                       cultural beliefs, and readiness for change of each participant
                      Participant receives positive feedback to reinforce good
                       nutrition habits
                      A nutrition goal is set (or tailored in AIM) which reflects the
                       participant’s choices that they have stated or ―see notes‖ is
                       selected as a goal and a typed goal is documented in the
                       ―Notes‖ section.
                      All documentation of goals and next steps in AIM reflect the
                       participant’s involvement and statements and not the sole
                       direction of the counselor
                      Nutrition education materials are appropriate, state
                       approved, and offered to the participant
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ARIZONA WIC PROGRAM                                            ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL               7-8                 REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education

                              Section B
       Participant-Centered Nutrition Education for Participants
                             (Continued)

Nutrition          Nutrition education may be conducted through individual or group
Education          sessions. Nutrition education materials are designed as tools to
Materials          reinforce nutrition education messages provided in a participant-
                   centered setting. The State of Arizona provides circle charts and
                   the Touching Hearts Touching Minds materials to reinforce
                   emotion based messages. These materials are available for
                   order through the warehouse. However, Local Agencies may
                   choose to develop their own materials. . Agency developed
                   nutrition education materials shall be submitted to the State for
                   approval. The State shall review the Local Agency developed
                   materials to ensure they meet the following criteria:
                    Accurate and relevant content based on current scientific
                      evidence
                    Support PCE
                    Contain cultural considerations
                    Be available in alternate languages as appropriate
                                              th
                    Be at no higher than 4 grade reading level
Local Agency       Local Agencies shall perform the following activities in
Responsibilities   carrying out their nutrition education responsibilities:
                     Make nutrition education available or enter into an agreement
                       with another agency to make nutrition education available to
                       all participants and caretakers.
                     Offer nutrition education through individual or group sessions.
                     Utilize State developed materials when working with
                       pregnant, postpartum, and breastfeeding women and parents
                       or caretakers of infants and children participating in Local
                       Agency services other than the WIC Program of program
                       benefits and services.
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ARIZONA WIC PROGRAM                                         ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL             7-9                REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education

                              Section B
       Participant-Centered Nutrition Education for Participants
                             (Continued)

Documentation of   Local Agency staff will document education in the Follow-up/
Education          Nutrition Education button in the Care Plan screen of the AIM
                   system. If problems in scheduling prevent a participant from
                   attending group classes, individual education will be provided.

Nutrition          A complete PCE assessment is required for all participants and is
Assessment         used as a tool to help identify participant’s needs and interests in
                   order to provide nutrition education relevant to the participant.




ARIZONA WIC PROGRAM                                          ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL             7-10                 REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education

                               Section C
                  Nutrition Education Care Standards

Policy            Each Local Agency will adopt and utilize the State Nutrition
                  Education Care Standards for nutrition education contacts in
                  accordance with FNS guidelines. (See Appendix H). All staff will
                  be trained on nutrition in varying degrees and depth, depending
                  on their responsibilities.



Nutrition         The Nutrition Education Care Standards in Appendix H was
Education Care    developed with Local Agencies as a guide for staff to offer
Standards         nutrition topics to pregnant women, infants and children that may
                  be of interest and relevance for their category.
                  The Standards are to be used as resource for staff to improve
                  their understanding of the nutrition needs of WIC participants.
                  The Standards provide guidance to staff when conducting
                  nutrition assessments, providing nutrition education, and
                  facilitating behavior change.




ARIZONA WIC PROGRAM                                        ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL            7-11                REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education

                               Section D
                     High-Risk Nutritionist Consults

Purpose           Certain participants are identified to be at higher risk and have
                  counseling needs beyond the scope of paraprofessional staff.
                  These participants benefit from more in-depth counseling
                  provided by a Registered Dietitian (RD), a BS Degree Nutrition
                  graduate (Degreed Nutritionist) or a Registered Dietetic
                  Technician (DTR).

Qualified Staff   Each Local Agency shall provide a Registered Dietitian as a WIC
                  Nutritionist to perform high-risk counseling, formula authorization,
                  and as necessary, certification of clients. The Local Agency will
                  provide the services of WIC Nutritionists in the number
                  proportional to the agency’s needs/caseload.
                  In place of the Registered Dietitian, and with prior approval from
                  the State, a designated WIC Nutritionist will have a minimum of
                  an undergraduate degree, from an accredited institution, in
                  nutrition (Community Nutrition, Public Health Nutrition, Nutrition
                  Education, Human Nutrition or Nutrition Science) or a related field
                  with an emphasis in nutritional science.
                  Note: Previous WIC and/or community health experience, and/or
                  a Master’s degree in a related subject are desirable.

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ARIZONA WIC PROGRAM                                          ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL             7-12                 REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education

                                 Section D
                       High-Risk Nutritionist Consults
                                (Continued)

Policy               The Arizona WIC Program stratified the nutrition risks to
                     medium and high risk. The Registered Dietitian or State-
                     Approved Nutritionist will see all participants meeting one of the
                     high-risk criteria outlined below during their current certification
                     period. A Degreed Nutritionist or a DTR will see all participants
                     meeting one of the medium risk criteria during their current
                     certification period. An International Board Certified Lactation
                     Consultant (IBCLC) may counsel participants with risk codes
                     602 / 603 in lieu of a Registered Dietitian.
                     The participant shall receive monthly issuance of food
                     instruments only, until they meet with the RD, IBLC or
                     Nutritionist as appropriate.
High Risk Criteria   The following high risks must be seen by the high-risk dietitian
                     or State-approved nutritionist, although it is at the Local Agency
                     discretion to include additional high risks as deemed necessary:
                       Risk 103 (infants and children underweight ≤5%)
                       Risk 132 (maternal wt. loss)
                       Risk 134 (failure to thrive—infants & children)
                       Risk 141 (low birth weight infants and children up to 12 mo.)
                       Risk 142 (premature infants and children up to 12 mo.)
                       Risk 302 (Gestational Diabetes for pregnant women) = RD
                            referral to MNT/Physician.
                       Risk 341 (Nutrient Deficiency Disease) = RD referral to
                            MNT/Physician.
                       Risk 602/603 (BF complications) = RD/IBCLC may refer to
                         staff with CBC/CLC after seen by RD/IBCLC
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ARIZONA WIC PROGRAM                                             ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                7-13                 REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education

                              Section D
                    High-Risk Nutritionist Consults
                             (Continued)

Medium            The following risks are considered medium risk and may be seen
Risk              by a State-Approved Nutritionist or DTR:
Criteria              Risk 103 (infants and children underweight from >5% and
                       <10%)
                    Risk 141 (low birth weight infants and children after 12 mo.
                       old after seen by an RD)
                    Risk 142 (premature infants and children after 12 mo. Old,
                         after seen by an RD)
                    Risk 201 (anemia) nutritionist ranges
                    Risk 101 (pre-pregnancy underweight)
                    Risk 131 (low maternal weight gain)
Documentation     The nutritionist will document the counseling session in the AIM
of Education      system in the Care Plan Notes button using SOAP, PIE, PES or
                  other equivalent format, including, at a minimum, assessment and
                  plan:
                    S: Subjective Information
                           Information the participant gives
                    O: Objective Information
                           Measurable information
                           Lab results, height, weight, Hgb, blood glucose, etc.
                    A: Assessment
                           Nutritional assessment of participant
                           Interpretation of subjective and objective information
                               as it relates to the participant’s nutritional status
                    P: Plan
                           Outline the plan to correct the problems indicated in
                               the assessment portion
                             Follow-up information

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ARIZONA WIC PROGRAM                                          ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL            7-14                  REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education

                              Section D
                    High-Risk Nutritionist Consults
                             (Continued)

High-Risk         Each Local Agency will develop written procedures for the
Referrals         Nutrition Education Specialists in order to refer medium and high-
                  risk participants to an appropriate nutritionist or Registered
                  Dietitian.
                  The Local Agency will monitor and evaluate their internal
                  procedures at least two times per year to ensure that participants
                  needing the referrals were seen by the appropriate personnel.
Nutritionist      When the participant no longer requires in-depth nutrition
Referral          counseling, the nutritionist will review the participant’s chart and
                  provide a nutrition care plan for the Nutrition Education Specialist
                  to follow with specific criteria for referral back to the nutritionist, if
                  needed.

                    Participants shall receive assessment and education by a
                     nutritionist for each certification period that a high risk is
                     identified.
                    Nutrition status is reassessed at each certification. If the same
                     high risk is identified as the previous certification period, the
                     participant still requires evaluation and follow-up by the
                     nutritionist.

                  Note: If the previous high-risk condition was identified as stable
                  and not requiring high-risk nutritionist intervention, the nutritionist
                  may note the referral back to the medium risk nutritionist or
                  nutrition education specialist for follow up. Documentation of this
                  referral and statement that staff must refer the participant back to
                  the high-risk nutritionist should status change must be recorded in
                  the Notes section of the Care Plan in AIM.
High-Risk         High-Risk and Medium risk participants may receive monthly
No-Shows          issuance of food instruments only, until they meet with the
                  registered dietitian or nutritionist.
Follow-up         The nutritionist’s discretion shall be used to determine whether to
                  continue to see the participant or to refer the participant back to
                  the Nutrition Education Specialist. The nutritionist will document
                  this in the Notes Section of AIM.
                  The Local Agency will develop written procedures providing the
                  Nutrition Education Specialists with guidance for referral back to
                  the nutritionist, as needed.


ARIZONA WIC PROGRAM                                             ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL               7-15                  REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education

                              Section E
        Education for Professional and Paraprofessional Staff
Realignment of   Arizona has recently recommended a restructuring of the WIC
the WIC          Workforce positions in order to meet the requirements of the
Workforce        USDA initiatives in revitalizing quality nutrition services. In
Structure        addition, training requirements have been aligned to the
                 competencies defined for each position. (Please see Appendix C).
                 Full implementation of the workforce structure is expected to take
                 place in FY2013.
Ensuring         Local Agencies will ensure competence of all professional and
Competence       paraprofessional staff who certify, provide nutrition education and
                 referrals, prescribe food packages for WIC participants, and/or
                 perform supervisory functions for the WIC Program
                 The Local Agency will be responsible for training and mentoring of
                 all staff and maintaining documentation to show that they have
                 met competencies required of a Certified Professional Authority
                 (CPA) and any other additional competencies required for their
                 positions.
Learning         1. The State Agency provides competency-based training through
Management           the WIC University for Nutritionists and WIC Directors. Local
System (LMS)         Agencies should send staff to the WIC University.

                 2. The Arizona (AZ) WIC Program Learning Management System
                    (LMS) is a web-based software used for delivering, tracking
                    and managing training/education. The purpose of LMS is to be
                    able to provide and track both online (e-learning) and instructor
                    led training to internal and external WIC staff which allows us to
                    maintain documentation to meet all federal and state reporting
                    requirements. The system can be accessed 24 hours a day, 7
                    days a week. (Please see section K).
                 The State Agency has developed an approach to training
WIC University   professionals. WIC University provides WIC 201 for nutritionists
                 and WIC 301 for WIC Directors. LMS courses have been
                 developed to replace WIC 101, and some courses are being
                 developed to replace certain instructor lead training.
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ARIZONA WIC PROGRAM                                         ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL            7-16                 REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education

                               Section E
         Education for Professional and Paraprofessional Staff
                             (Continued)
Staff Mentoring   Local Agencies will evaluate the performance of each employee
and Evaluation    annually through a review of client records as well as observation
                  of staff performance. The completed employee evaluation will be
                  maintained in the employee’s file. Key areas of evaluation
                  include:
                    Certification Process
                    Nutrition Assessment
                    Nutrition Counseling
                    Breastfeeding Counseling and Promotion
                    Customer Service

                  In addition, Local Agencies will provide one-on-one mentoring to
                  staff that will include feedback and guidance in a positive way
                  following the Counseling Observation Guide. (See Appendix C)
Education Plan    Local Agencies will provide and make available, all training
                  necessary to new employees prior to their certification as a
                  Competent Professional Authority (CPA).
                  In addition, Local Agencies will provide a minimum of 48 hours of
                  documented training for each staff member in each fiscal year.
                  Although some level of training will be conducted each quarter,
                  training does not have to be evenly distributed over the four
                  quarters of the fiscal year.
                  At least 28 hours of nutrition education will be in:
                    Nutrition Risk
                    Food Package
                    Counseling

                  At least 8 hours of staff education will focus on breastfeeding.
                  An additional 12 hours of WIC related education will be provided
                  on the following:
                    Civil Rights training is required annually for all staff


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ARIZONA WIC PROGRAM                                          ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL             7-17                 REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education

                              Section E
        Education for Professional and Paraprofessional Staff
                            (Continued)

Education Plan      It is required by the USDA that Local Agencies incorporate
(Continued)          task-appropriate breastfeeding promotion and support
                     training into orientation programs for new staff involved in
                     direct contact with WIC clients
                    Local Agencies must also have a plan to ensure that women
                     have access to breastfeeding promotion and support
                     activities during the prenatal and postpartum periods

                  Other training may also include topics such as:
                    Program rules
                    WIC management information system (AIM)
                    Food instrument issuance
                    Referral procedures
                    Computer skills
                    Customer service
                    Car seat safety
                  Personal safety
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ARIZONA WIC PROGRAM                                        ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL            7-18                REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education

                               Section E
         Education for Professional and Paraprofessional Staff
                             (Continued)
Agency Training    As the LMS courses become ready, staff will take and complete
Files              the required courses according to State schedule.
                   In a central file, each Local Agency will maintain a record of all
                   continuing education provided.
                   Central training files will include:
                    • Agenda, outline and teaching materials used for each local in-
                      service training provided
                    • A list of participants, speakers, dates and time spent in
                      training
                    • Agenda and outline of meetings which Local Agency staff
                      attend (e.g., Breastfeeding Training, Statewide Staff
                      Meetings)
                    • College or University courses taken, the name of the course
                      and grade
                   Note: Local Agencies may use the ADHS LMS System to
                   document all the training provided to each staff.
Staff Training     Current training files for each paraprofessional will include:
Files
                    • A summary of needs based on job functions that are updated
                      annually
                    • A completed competency Certification Checklist with dates of
                      training and evaluation results
                   Documentation of training provided
Documentation of   Documentation consists of a list of dates, topics presented and
Training           time spent in training. Date and time summaries will be
                   separated by fiscal year in order to verify the required 48 hours
                   per year have been provided. Documentation comprises copies
                   of pre-and post-tests or other methods of evaluation. Also
                   included is documentation of follow-up training, which is required
                   if competency is not met.
                   Note: The name of the workshop or in-service training is
                   sufficient when the agenda and training outline are retained in the
                   Local Agency training file.
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ARIZONA WIC PROGRAM                                           ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL               7-19                REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education

                               Section F
                    Nutrition Education Resources
LMS Courses       The following is a listing of LMS courses that will be available for
                  staff to complete:

                     Civil Rights
                     CLAS Training
                     Introduction to WIC
                     Introduction to AIM
                     Hematology
                     Anthropometrics
                     Breast Feeding
                     Basic Nutrition
                     Pre-Natal Nutrition
                     Child Nutrition
                     Post Partum Nutrition
                     Motivational Interviewing/PCE
Nutrition         Nutrition Education and Other Program Materials are available for
Education         local agencies to order on the www.azwic.gov website.. (See
Materials         Appendix F)
Flyers            Arizona WIC Approved Food List
Care Plan         The care plans available through the AIM system will be used to
                  support nutrition education. (See Appendix H)
Training Manual   Arizona WIC Program Training Manual (2006) consists of:
                    WIC 201 (Training Materials for WIC Nutritionists)
                  WIC 301 (Training Materials for WIC Directors)
Lab Manual        Lab Procedure Manual (2004)
Anthropometric
                  Anthropometric Lab Manual (2007)
Lab Manual
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ARIZONA WIC PROGRAM                                          ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL             7-20                 REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education

                                  Section F
                       Nutrition Education Resources
                                 (Continued)
Dietetic Education   The Dietetic Education Program (DEP) is a two-year college
Program              program approved by the American Dietetic Association for the
                     training of nutrition paraprofessionals in the delivery of nutrition
                     care services.
                        DEP utilizes competency based, self-paced modules and is
                          available to local WIC agencies for the training of
                          paraprofessionals.
                        Local Agencies may provide paid time for employees to work
                          on DEP modules or group time for DEP classes. When
                          documented, this time applies to the 48 hours of continuing
                          education required per employee each year.
                     The State Agency funds full or partial tuition for Local Agency
                     staff when requested and approved in the Local Agencies budget
                     each fiscal year.
WIC Nutrition        The WIC Nutrition Assessment Certificate is a 15 credit
Assessment           certification developed by Central Arizona College to meet the
Certificate          competencies required by VENA. This certificate is available to
                     WIC staff.

                        Local Agencies may provide paid time for employees to work
                          on modules or group time for certificate classes. When
                          documented, this time applies to the 48 hours of continuing
                          education required per employee each year.
                     The State Agency funds full or partial tuition for Local Agency
                     staff when requested and approved in the Local Agencies budget
                     each fiscal year.
                                                                   Continued on Next Page




ARIZONA WIC PROGRAM                                            ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                7-21                REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education

                               Section F
                    Nutrition Education Resources
                              (Continued)
Program           The United States Department of Agriculture (USDA) allows the
Incentives        State, when funds are available, to purchase incentive and
                  outreach items for WIC. The items would be used for teaching
                  health messages or to inform people about the WIC Program.
                  They would not promote a certain Local Agency’s logo or be
                  items that would be seen or used by staff only. Items should
                  include the State WIC number: 1-800-2525-WIC (1-800-252-
                  5942).
                  These items are allowable for three purposes: outreach,
                  breastfeeding promotion, and nutrition education.
                  An example of an incentive item currently provided by the Arizona
                  Department of Health Services is the Breastfeeding shawls.
                  Program incentive items for Nutrition Education should:
                    Be targeted to participants
                    Contain a WIC-approved nondiscrimination statement for
                     publications or other printed material that also include any
                     program information
                    Have a clear and useful connection to particular WIC nutrition
                     education messages
                    Either convey enough information to be considered
                     educational or be utilized by participants to reinforce nutrition
                     education contacts
                    Have value as nutrition education aids that equal or outweigh
                      other uses
                    Be distributed to the audience for which the items were
                     designed (e.g., tippy cups distributed to mothers of infants
                     who are learning or will be learning to drink from a cup during
                     a relevant nutrition education contact)
                    Be reasonably and necessarily priced
                  Other examples include calendars that contain important nutrition
                  education messages and refrigerator magnets with nutrition or
                  breastfeeding information on them.

                                                                Continued on Next Page


ARIZONA WIC PROGRAM                                         ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL            7-22                 REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education

                               Section F
              Nutrition Education Resources (Continued)
Program           Program incentive items for Breastfeeding Promotion and
Incentives        Support should:
(Continued)         Contain a WIC-approved nondiscrimination statement for
                      publications or other printed material that also include any
                      program information
                    Have a clear and useful connection to promoting and
                      supporting breastfeeding among current WIC participants
                    Either convey information that encourages and supports
                      breastfeeding in general, informs participants about the
                      benefits of breastfeeding, or offers support and
                      encouragement for women to initiate and continue
                      breastfeeding
                    Have value as breastfeeding promotion and support items
                      that equal or outweigh other uses
                    Be distributed to the audience for which the items were
                      designed
                    Be reasonable and necessary costs
                  Examples include: t-shirts, buttons or other items of nominal
                  value with a breastfeeding promotion or support message (e.g.,
                  ―Breast Fed is Best Fed‖).
                  Careful consideration should be given to the public perception of
                  funds spent on items. Like any other administrative cost, these
                  expenditures are subject to review, audit, and public scrutiny.
                  WIC should be prepared for public challenges and be able to
                  justify their incentive expenditures.
                  It is mandatory in WIC, that the clinics create a positive
                  environment that endorses breastfeeding as the preferred method
                  of infant feeding.
                  Each Local Agency must have a designated staff person to
                  coordinate breastfeeding promotion and support activities.
                  It is required by the USDA that Local Agencies incorporate task-
                  appropriate breastfeeding promotion and support training into
                  orientation programs for new staff involved in direct contact with
                  WIC clients. Local Agencies must also have a plan to ensure that
                  women have access to breastfeeding promotion and support
                  activities during the prenatal and postpartum periods.


ARIZONA WIC PROGRAM                                         ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL            7-23                 REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education


              Appendix A: Nutrition Education Materials

                              See following pages




ARIZONA WIC PROGRAM                                 ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL           7-24          REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education


                            Appendix B:
          Professional and Paraprofessional Training Dates

                              See following pages




ARIZONA WIC PROGRAM                                 ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL           7-27          REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education


                                                     Certification Specialist

    Core                   Possible                           Proposed                                                    Hours Required
                                            Start Date                      Methodology/Source          Evaluation
 Competencies             Resources                      Completion Date                                                  to learn material
                     Civil Rights          Week 1        Week 4 (Civil      Civil Rights – LMS       Civil Rights Final
                                                         Rights)                                     Exam
                                           Week 1        Week 6             Introduction to WIC      Introduction to
                     Introduction to WIC                 (Introduction to   Competency Checklist     WIC Final Exam
                     - including key                     WIC)               (LMS) completed by       Introduction to
WIC Program          nutrients and WIC                                      designated local         WIC Competency
                     foods and basic                                        agency trainer           Checklist
                     breastfeeding                                          Individual instruction   Other-local
                     benefits and                                           by Lead Trainer or       agency specific
                     information                                            designee and hands-      evaluation
                                                                            on practice
AIM 101 –Getting     AIM 101 - LMS         Week 1        Week 6             AIM 101 LMS Course       AIM 101 Final
Started, Appt                                                               and Competency           Exam
scheduling, Pre-                                                            Checklist                and Competency
Certs                                                                                                Checklist
AIM 102-             AIM 102 – LMS         Week 2        Week 6             AIM 102 LMS Course       AIM 102 Final
Certification,                                                              and Competency           Exam
Participant Reg,                                                            Checklist                and Competency
Medical, Overview                                                                                    Checklist
of the rest of the
process; Printing
forms
AIM 104 –            AIM 104 – LMS         Week 4        Week 12            AIM 104 LMS Course       AIM 104 Final
Additional AIM                                                              and Competency           Exam
Functions                                                                   Checklist                and Competency
                                                                                                     Checklist




ARIZONA WIC PROGRAM                                                                                        ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education


                                          Certification Specialist, Continued
      Core                Possible                      Proposed                                                      Hours Required
                                         Start Date                     Methodology/Source           Evaluation
 Competencies           Resources                     Completion Date                                                 to learn material
Anthropometric     Anthropometric &     Week 2        Week 6            Anthropometric and        Anthropometric
and                Hemotological Data                                   Hematological Data        and
Hematological      Collection LMS                                       Collection LMS            Hematological
Data Collection    Course (TBD by                                       Course and                Collection Final
                   Dec 2009) – which                                    Competency Checklist      Exam and
                   includes basic                                                                 Competency
                   concepts of why                                      Scheduled with State      Checklist
                   nutrition                                            trainer and in-services
                   measurements are                                     and/or mentorship by      Local agency
                   being taken                                          Lead Trainer              and/or State
                                                                                                  evaluation
                   Anthropometric and
                   Lab Manual

                   State and/or Local
                   Agency
                   Instructor-led
                   Training
Customer Service   WIC Works            Week 2        Week 6            Individual instruction    WIC Works
                   -OR-                                                 by Lead Trainer           completion of the
                   ADHS DVD                                                                       final exam
                                                                        WIC Works Learning
                                                                        Online Modules –          Local agency
                                                                        Customer Service          evaluation
                                                                        module within
                                                                        ―Communicating with
                                                                        Participants‖
                                                                        -AND-
                                                                        Viewing of ADHS DVD




ARIZONA WIC PROGRAM                                                                                     ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                             REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education


                                              Certification Specialist, Continued
       Core             Possible                            Proposed                                                     Hours Required
                                            Start Date                     Methodology/Source           Evaluation
 Competencies         Resources                          Completion Date                                                 to learn material
Communication      WIC Works               Month 3       Month 6           Individual instruction    WIC Works
and Rapport        -OR-                                                    by Lead Trainer           completion of the
Building           ADHS-DVD                                                                          final exam
                                                                           WIC Works –
                                                                           ―Communicating with       Local agency
                                                                           Participants‖             evaluation
                                                                           -AND-
                                                                           Viewing ADHS DVD
Multicultural      WIC Works               Month 3       Month 6           Individual instruction    Local agency
Awareness                                                                  by Lead Trainer;          evaluation
                   Healthstream
                   https://healthstream.                                   WIC Works                 Intro to CLAS
                   com/HLC/mphc                                                                      Final Exam and
                                                                           Healthstream              Competency
                   Intro to CLAS LMS                                                                 Checklist OR
                   Course                                                  Monthly meeting           Passing of Pre-
                                                                           lesson and activities     test

                                                                           Intro to CLAS LMS
                                                                           Course and
                                                                           Competency Checklist
Missed Trainings   Any ADHS- DVD’s         Month 6       Month 12          Scheduled with State
                                                                           trainer and in-services
                                                                           and/or mentorship by
                                                                           Lead Trainer




ARIZONA WIC PROGRAM                                                                                       ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                               REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education
                                                Nutrition Education Specialist
    Core                  Possible                        Proposed                                                      Hours Required
                                         Start Date                       Methodology/Source          Evaluation
 Competencies           Resources                      Completion Date                                                  to learn material
                     Civil Rights      Week 1          Week 4 (Civil      Civil Rights LMS         Civil Rights Final
                                                       Rights)            courses                  Exam

                                       Week 1          Week 6             Introduction to WIC      Introduction to
                                                       (Introduction to   Competency Checklist     WIC Final Exam
                                                       WIC)               (LMS) - completed by     Introduction to
WIC Program
                                                                          designated local         WIC Competency
                     Introduction to
                                                                          agency trainer.          Checklist
                     WIC
                                                                          Individual instruction   Other-local
                                                                          by Lead Trainer or       agency specific
                                                                          designee and hands-      evaluation
                                                                          on practice
AIM 101 –Getting     AIM 101 - LMS     Week 1          Week 6             AIM 101 LMS Course       AIM 101 Final
Started, Appt                                                             and Competency           Exam
scheduling, Pre-                                                          Checklist                and Competency
Certs                                                                                              Checklist
AIM 102-             AIM 102 – LMS     Week 2          Week 6             AIM 102 LMS Course       AIM 102 Final
Certification,                                                            and Competency           Exam
Participant Reg,                                                          Checklist                and Competency
Medical, Overview                                                                                  Checklist
of the rest of the
process; Printing
forms
AIM 103 –            AIM 103 - LMS     Week 3          Week 8             AIM 103 LMS Course       AIM 103 Final
Overview of cert                                                          and Competency           Exam
process; health                                                           Checklist                and Competency
history; Nutrition                                                                                 Checklist
education screen;
care plan;
nutrition
education;
medical referrals;
food package




ARIZONA WIC PROGRAM                                                                                      ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                              REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education

                                          Nutrition Education Specialist, Continued
       Core              Possible                          Proposed                                                       Hours Required
                                            Start Date                     Methodology/Source           Evaluation
 Competencies           Resources                        Completion Date                                                  to learn material
AIM 104 –            AIM 104 – LMS        Week 4         Week 12           AIM 104 LMS Course        AIM 104 Final
Additional AIM                                                             and Competency            Exam
Functions                                                                  Checklist                 and Competency
                                                                                                     Checklist
Nutrition and Risk   Nutrition and Risk   Week 3         Week 8            Nutrition and Risk        Nutrition and Risk
Assessment           Assessment LMS                                        Assessment Course         Assessment Final
                     Course (TBD)                                          and Competency            Exam and
                                                                           Checklist                 Competency
                     Local agency in-                                                                Checklist OR
                     service/training                                      Individual instruction    Passing of LMS
                                                                           by local agency trainer   Pretest

                                                                                                     Local agency
                                                                                                     evaluation


Anthropometric       Anthropometric &     Week 2         Week 6            Anthropometric and        Anthropometric
and                  Hematological                                         Hematological Data        and
Hematological        Data Collection                                       Collection LMS            Hematological
Data Collection      LMS Course                                            Course and                Collection Final
                     (TBD by Dec                                           Competency Checklist      Exam and
                     2009)                                                                           Competency
                                                                           Scheduled with State      Checklist
                     Anthropometric                                        trainer and in-services
                     and Lab Manual                                        and/or mentorship by      Local agency
                                                                           Lead Trainer              and/or State
                     State and/or                                                                    evaluation
                     Local Agency
                     Instructor-led
                     Training




ARIZONA WIC PROGRAM                                                                                        ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education

                                     Nutrition Education Specialist, Continued
      Core             Possible                        Proposed                                                   Hours Required
                                       Start Date                     Methodology/Source          Evaluation
 Competencies         Resources                     Completion Date                                               to learn material
Basic Nutrition    Basic Nutrition   Month 3        Month 6           Basic Nutrition LMS      Basic Nutrition
                   LMS Course                                         Course and               Final Exam and
                   (TBD by Dec                                        Competency Checklist     Competency
                   2009)                                                                       Checklist OR
                                                                      Monthly in-services by   Passing of LMS
                   CAC                                                Lead Trainer             Pre-test

                   RD in-services                                     Nutrition 104 CAC        Local agency
                                                                      course                   evaluation

                                                                      WIC Works Learning
                                                                      Online Modules

                                                                      Online AZ WIC
                                                                      Training Manual
Nutrition During   Life Cycle        Month 3            Month 6       Nutrition During Life    Life Cycle Final
the Life Cycle     Nutrition LMS                                      Cycle LMS Course         Exam and
                   Course (TBD by                                     and Competency           Competency
                   Dec 2009)                                          Checklist                Checklist OR
                                                                                               Passing of LMS
                   Central Arizona                                    CAC                      Pre-test
                   College
                                                                      Monthly in-services by   Local agency
                   RD in-services                                     Lead Trainer             evaluation

                                                                      WIC Works Learning
                                                                      Online Modules

                                                                      Online AZ WIC
                                                                      Training Manual.




ARIZONA WIC PROGRAM                                                                                  ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                          REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education

                                          Nutrition Education Specialist, Continued
       Core               Possible                          Proposed                                                     Hours Required
                                            Start Date                     Methodology/Source          Evaluation
  Competencies           Resources                       Completion Date                                                 to learn material
Infant Nutrition     Infant Nutrition     Month 3        Month 6           Infant Nutrition WIC     Infant Nutrition
Series               WIC Works                                             Works courses in LMS     Final Exam and
                     course in LMS –                                       and Certificate of       Competency
                     3 courses (0-6                                        Completion               Checklist OR
                     months, 6-12                                                                   Passing of LMS
                     months, Formula                                       CAC                      Pre-test
                     Basics)
                                                                           Monthly in-services by   Local agency
                     CAC                                                   Lead Trainer             evaluation

                     RD in-services                                        WIC Works Learning
                                                                           Online Modules

                                                                           Online AZ WIC
                                                                           Training Manual.
Maternal Nutrition   Maternal Nutrition   Month 3        Month 6           Maternal Nutrition       Maternal Nutrition
                     LMS Course                                            LMS Course and           Final Exam and
                     (TBD by Dec                                           Competency Checklist     Competency
                     2009)                                                                          Checklist OR
                                                                           Monthly in-services by   Passing of LMS
                     CAC                                                                            Pre-test
                                                                           Lead Trainer
                     WIC Works                                                                      Local agency
                                                                           WIC Works Learning       evaluation
                     RD in-services                                        Online Modules

                                                                           Online AZ WIC
                                                                           Training Manual.




ARIZONA WIC PROGRAM                                                                                       ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                               REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education

                                 Nutrition Education Specialist, Continued
        Core        Possible                       Proposed                                                  Hours Required
                                   Start Date                     Methodology/Source          Evaluation
 Competencies      Resources                    Completion Date                                              to learn material
Postpartum      Postpartum       Month 3        Month 6           Postpartum Nutrition     Postpartum
Nutrition       Nutrition LMS                                     LMS Course and           Nutrition Final
                Course (TBD by                                    Competency Checklist     Exam and
                Dec 2009)                                                                  Competency
                                                                  CAC                      Checklist OR
                CAC                                                                        Passing of LMS
                                                                  Monthly in-services by   Pre-test
                RD in-services                                    Lead Trainer
                                                                  WIC Works Learning       Local agency
                                                                  Online Modules           evaluation

                                                                  Online AZ WIC
                                                                  Training Manual

                                                                  CBC course
Breastfeeding   Breastfeeding    Month 3        Month 6           Breastfeeding LMS        Breastfeeding
                LMS Course                                        Course and               Final Exam and
                (TBD by Dec                                       Competency Checklist     Competency
                2009)                                                                      Checklist OR
                                                                  Monthly in-services by   Passing of LMS
                CBC                                               Lead Trainer             Pre-test

                WIC Works                                         CBC course               Local agency
                                                                                           evaluation
                CAC                                               WIC Works Learning
                                                                  Online Modules

                                                                  CAC

                                                                  Online AZ WIC
                                                                  Training Manual




ARIZONA WIC PROGRAM                                                                             ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                     REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education

                                     Nutrition Education Specialist, Continued
       Core            Possible                       Proposed                                                     Hours Required
                                       Start Date                     Methodology/Source          Evaluation
 Competencies         Resources                     Completion Date                                                to learn material
Child Nutrition    Child Nutrition   Month 3           Month 6        Child Nutrition LMS      Child Nutrition
                   LMS Course                                         Course and               Final Exam and
                   (TBD by Dec                                        Competency Checklist     Competency
                   2009)                                                                       Checklist OR
                                                                      CAC                      Passing of LMS
                   Healthy Weight                                                              Pre-test
                   for Kids (CAC)                                     Monthly in-services by
                                                                      Lead Trainer             Local agency
                   WIC Works                                                                   evaluation
                                                                      WIC Works Learning
                                                                      Online Modules

                                                                      Online AZ WIC
                                                                      Training Manual

                                                                      CBC course
Customer Service   WIC Works         Week 2         Week 6            Individual instruction   WIC Works
                   -OR-                                               by Lead Trainer          completion of the
                   ADHS DVD                                                                    final exam
                                                                      WIC Works Learning
                                                                      Online Modules –         Local agency
                                                                      Customer Service         evaluation
                                                                      module within
                                                                      ―Communicating with
                                                                      Participants‖
                                                                      -AND-
                                                                      Viewing of ADHS DVD
Communication      WIC Works         Month 3        Month 6           Individual instruction   WIC Works
and Rapport        -OR-                                               by Lead Trainer          completion of the
Building           ADHS-DVD                                                                    final exam
                                                                      WIC Works –
                                                                      ―Communicating with      Local agency
                                                                      Participants‖            evaluation
                                                                      -AND-
                                                                      Viewing ADHS DVD

ARIZONA WIC PROGRAM                                                                                 ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                         REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education

                                           Nutrition Education Specialist, Continued
        Core            Possible                             Proposed                                                  Hours Required
                                             Start Date                     Methodology/Source          Evaluation
 Competencies          Resources                          Completion Date                                              to learn material
Critical Thinking    WIC Works             Month 3        Month 6           Individual instruction   Local agency
                                                                            by Lead Trainer          evaluation

                                                                            Monthly meeting
                                                                            lesson and activities

                                                                            WIC Works Learning
                                                                            Online Modules

                                                                            State VENA Classes
                                                                            (DVD)
Participant          PCE LMS Course        Month 3        Month 6           PCE LMS Course and       PCE Final Exam
Centered Nutrition   (TBD by Dec                                            Competency Checklist     and Competency
Education            2009)                                                                           Checklist
                     -OR-                                                   Altarum DVD
                     Altarum DVD                                                                     Viewing of DVD
Multicultural        WIC Works             Month 3        Month 6           Individual instruction   Local agency
Awareness                                                                   by Lead Trainer;         evaluation
                     Healthstream
                     https://healthstrea                                    WIC Works                Intro to CLAS
                     m.com/HLC/mphc                                                                  Final Exam and
                                                                            Healthstream             Competency
                     Intro to CLAS                                                                   Checklist OR
                     LMS Course                                             Monthly meeting          Passing of Pre-
                                                                            lesson and activities    test

                                                                            Intro to CLAS LMS
                                                                            Course and
                                                                            Competency Checklist
Facilitating Group   ―Finding the          Month 3        Month 6           LMS Video & Practice     Local agency
Discussion           Teacher Within‖                                                                 observation
                     ADHS – DVD

                     RD in-services


ARIZONA WIC PROGRAM                                                                                       ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                               REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education

                                      Nutrition Education Specialist, Continued
      Core              Possible                        Proposed                                                     Hours Required
                                        Start Date                     Methodology/Source           Evaluation
 Competencies          Resources                     Completion Date                                                 to learn material
Touching Hearts-     ADHS-DVD         Month 3        Month 6           3 ADHS DVDs               Local agency
Touching Minds                                                         (September 2008,          observation
Nut. Ed. Trainings                                                     January/February
                                                                       2009, May/June 2009)
Nutrition Care       Nutrition Care   Month 3        Month 6           Nutrition Care            Nutrition Care
Standards            Standards LMS                                     Standards LMS             Standards Final
                     Course                                            Course and                Exam and
                                                                       Competency Checklist      Competency
                     RD in-services                                                              Checklist OR
                                                                       Monthly meetings and      Passing of Pre-
                                                                       activities                test

                                                                                                 Local Agency
                                                                                                 evaluation
Missed Trainings     Any ADHS-        Month 6        Month 12          Scheduled with State
                     DVD’s                                             trainer and in-services
                                                                       and/or mentorship by
                                                                       Lead Trainer
Communication        WIC Works        Month 3        Month 6           Individual instruction    WIC Works
and Rapport          -OR-                                              by Lead Trainer           completion of the
Building             ADHS-DVD                                                                    final exam
                                                                       WIC Works –
                                                                       ―Communicating with       Local agency
                                                                       Participants‖             evaluation
                                                                       -AND-
                                                                       Viewing ADHS DVD




ARIZONA WIC PROGRAM                                                                                   ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                           REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education

       Core         Possible                              Proposed                                                  Hours Required
                                          Start Date                     Methodology/Source          Evaluation
 Competencies      Resources                           Completion Date                                              to learn material
Multicultural   WIC Works                Month 3       Month 6           Individual instruction   Local agency
Awareness                                                                by Lead Trainer;         evaluation
                Healthstream
                https://healthstream.                                    WIC Works                Intro to CLAS
                com/HLC/mphc                                                                      Final Exam and
                                                                         Healthstream             Competency
                Intro to CLAS LMS                                                                 Checklist OR
                Course                                                   Monthly meeting          Passing of Pre-
                                                                         lesson and activities    test

                                                                         Intro to CLAS LMS
                                                                         Course and
                                                                         Competency Checklist




                                        Nutrition Education Specialist, Continued




ARIZONA WIC PROGRAM                                                                                    ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                            REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education
Missed Trainings   Any ADHS- DVD’s   Month 6   Month 12   Scheduled with State
                                                          trainer and in services
                                                          and/or mentorship by
                                                           Lead Trainer




ARIZONA WIC PROGRAM                                                                 ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                         REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education

                Appendix C: AIM Competencies

                              See following pages




ARIZONA WIC PROGRAM                                   ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL           7-41          REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education

                                                          Clerk Competencies

                                                            Clerk Competencies
                                                                           11. To describe the clerk role in supporting/promoting
      1. To understand that WIC is a national program administered
                                                                           breastfeeding
      by the USDA and describe the purpose of the WIC program.
                                                                           12. To describe the clerk role in providing good customer
      2. To successfully logon to the AIM System
                                                                               service

      1. To correctly identify and appropriately utilize the different     13. To describe common anthropometric and
         parts of the AIM System windows                                   biochemical risks
                                                                           14. To understand the clerk role in promoting good clinic
      4. To successfully navigate through the AIM System
                                                                               flow
                                                                           15. To understand the clerk role in handling customer
      5. To accurately perform a query
                                                                               complaints and civil rights complaints

      6. To successfully utilize appropriate help functions                16. To successfully print and distribute food instruments

      7. To identify eligibility criteria and successfully pre-certify a
                                                                           17. To successfully void and reissue food instruments
      client
                                                                           18. To understand and successfully run appropriate
      8. To successfully transfer in-state and out-of-state clients
                                                                               reports

      9. To schedule a new appointment


      10. To print an appointment notice




ARIZONA WIC PROGRAM                                                                                             ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                     REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education

                                   Certification Specialist Competencies, Continued

                                                       AIM Competencies
      1. To describe the purpose of the WIC program and identify         12. To describe the certification specialist role in
         eligibility criteria                                                supporting/promoting breastfeeding
                                                                         13. To correctly identify the guidelines for weighing
      2. To successfully logon to the AIM System
                                                                             and measuring clients
      3. To correctly identify and appropriately utilize the different   14. To describe common anthropometric and
         parts of the AIM System windows                                     biomedical risks
                                                                         15. To successfully print and distribute food
      4. To successfully navigate through the AIM System
                                                                             instruments
                                                                         16. To successfully void and reissue food
      5. To accurately perform a query
                                                                             instruments
                                                                         17. To understand and successfully run
      6. To successfully utilize appropriate help functions
                                                                             appropriate reports

      7. To successfully pre-certify a client

      8. To successfully transfer in-state and out-of-state clients

      9. To schedule a new appointment

      10. To successfully determine and document income eligibility
          using the Income Calculator

      11. To print an appointment notice




ARIZONA WIC PROGRAM                                                                                              ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                      REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education

                                        Nutrition Education Specialist Competencies

                                                          AIM Competencies
 1. To describe the purpose of the WIC program and identify               12. To describe the nutrition education specialist role in
    eligibility criteria                                                      supporting/promoting breastfeeding
                                                                          13. To correctly identify the guidelines for weighing and
 2.   To successfully logon to the AIM System
                                                                              measuring clients
 3. To correctly identify and appropriately utilize the different parts   14. To describe common anthropometric, biomedical,
    of the AIM System windows                                                 medical, and dietary risks

 4.   To successfully navigate through the AIM System                     15. To successfully complete a diet assessment

 5. To accurately perform a query                                         16. To successfully transition from assessment to education

                                                                          17. To offer participant centered nutrition education based on
 6. To successfully utilize appropriate help functions
                                                                              client needs and interests

 7. To successfully pre-certify a client                                  18. To create a client care plan based on client information

                                                                          19. To understand and assign the appropriate food package
 8. To successfully transfer in-state and out-of-state clients
                                                                              for a client

 9. To schedule a new appointment                                         20. To successfully print and distribute food instruments

 10. To successfully determine and document income eligibility
                                                                          21. To successfully void and reissue food instruments
     using the Income Calculator

 11. To print an appointment notice                                       22. To understand and successfully run appropriate reports

                                                                          23. To demonstrate their skills to provide nutrition education
                                                                              to WIC participants through role play



ARIZONA WIC PROGRAM                                                                                                ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                        REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education


                                               Staff Training Competencies
                                              WIC 201 – Nutritionist Training

                                                        WIC 201 Competencies
         1. To understand WIC history, mandates, categories,
                                                                            8. To correctly order nutrition education
            priorities, targeting populations, role of USDA, State office
                                                                               handouts and supplies
            and Local Agency Nutritionists
                                                                            9. To provide breastfeeding support, including
         2. To understand and describe WIC nutrition risk factors
                                                                               pumps, incentives, referrals, and education
         3. To develop effective client care plans and interventions        10. To conduct accurate internal audits
         4. To provide effective participant centered counseling to WIC     11. To develop quality staff in-services for
            clients, especially high risk clients                               continuing education
                                                                            12. To develop effective outreach activities for
         5. To accurately assess client dietary behaviors
                                                                                the targeted audience
                                                                            13. To appropriately handle customer complaints
         6. To appropriately authorize special formulas
                                                                                and civil rights complaints
         7. To correctly run AIM reports




ARIZONA WIC PROGRAM                                                                                            ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                    REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education

                                   Staff Training Competencies - WIC 301 Director Training
                                                                 WIC 301 Competencies
1. To prepare program budget (contract) proposals, participate in contract       18. To manage clinic operations: Load clinic hours, appointments
   negotiations, and monitor compliance                                              and schedules in AIM
2. To manage caseload and priority distribution with an outreach plan,
                                                                                 19. To understand and follow federal processing standards
   appointment scheduling, waiting lists, and waiting lists sorted by priority
3. To submit reports and revisions in a timely manner according to the AZ
                                                                                 20. To ensure separation of duties in Local Agency clinics
   P&P manual, ―Financial Management‖ chapter
4. To understand process for submitting Contractor Expenditure Reports
                                                                                 21. To appropriately resolve client complaints
   (CER’s)
5. To order forms and supplies from the Office of Nutrition Services (ONS)
                                                                                 22. To develop an appropriate outreach plan
   Administrative Support Supervisor at the State WIC office
6. To submit inventory list annually                                             23. To update and confirm referral lists
                                                                                 24. To develop a Nutrition Care Plan for each risk factor, including
7. To obtain State approval prior to purchasing capital equipment as defined
                                                                                     the procedures for identifying high risk clients and
   in AZ P&P
                                                                                     documentation of an internal referral process
8. To understand the community needs assessment for vendor authorizations        25. To develop procedures for internal referrals to nutritionist
9. To develop, implement and monitor procedures to ensure food instrument
                                                                                 26. To develop and update Local Agency WIC P&P manual
    security and accountability
10. To ensure the accuracy of food instrument issuance and redemption            27. To document and maintain files according to the AZ P&P ,
    training                                                                         ―Records and Reports‖ chapter
                                                                                 28. To understand Community Nutrition Team Programs and
11. To ensure that maximum levels of food are not exceeded
                                                                                     Services
12. To refer all vendor requests/complaints/issues to the State Agency for
                                                                                 29. To identify Healthy Arizona 2010 Nutrition Objectives
    follow-up
13. To follow-up on all vendor complaints regarding participants that are
                                                                                 30. To understand the role of the AIM system
    forwarded to you by the State Agency
14. To notify the State Agency of all claims of lost and/or stolen food          31. To understand Children's Rehabilitative Services, Early
    instruments                                                                      Intervention Program, and High Risk Prenatal Services
15. To complete and submit the Redemption Error Report by due date               32. To appropriately use AIM management functionality
16. To develop and perform quality assurance reviews or other continuous
                                                                                 33. To provide daily staff supervision
    quality improvement program regularly
17. To prepare and present an annual review/evaluation for each staff member     34. To understand how to run AIM reports




ARIZONA WIC PROGRAM                                                                                                         ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                                 REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education

                                      AIM Local Agency Administration Competencies

                                                  AIM Administration Competencies
1. To create a new employee in the AIM computer system

2. To edit personnel information in the AIM computer system.

3. To appropriately use the outreach/referrals section of the AIM
   computer system.

4. To complete the time study/daily log in the AIM computer system.

5. To complete the annual WIC cost summary in the AIM computer
   system.

6. To run reports in the AIM computer system.

7. To assign passwords and roles to new users and update passwords
   and roles for existing users of the AIM computer system.

8. To run Caseload reports in the AIM computer system.

9. To demonstrate understanding of how to appropriately monitor FI
   stock and MICR cartridge inventory.

10. To understand how to identify FI number issuance.

11. To use the Outputs section of the AIM computer system.

12. To demonstrate an understanding of how to track/monitor help desk
    calls.
13. To demonstrate an understanding of how to report a technical
    problem.




ARIZONA WIC PROGRAM                                                                  ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                          REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education

                   Appendix D: VENA Competencies

                              See Following Page




ARIZONA WIC PROGRAM                                ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL              7-48      REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education

                                                  Certification Specialist
Minimum Requirements: High School Diploma or GED
Competency       Knowledge and Skills                  Performance Expected                       Target   Comments     Date
Revised 8.25.09                                                                                   Date                  Completed
1. Understands   Knowledge of:                         Have the ability to assess participant’s
WIC program                                            understanding of information provided.
requirements.
                 WIC Program services, Participant     Explains the WIC Program, the
                 categories,                           eligible population, income
                 WIC foods and key nutrients in        qualifications, and the services
                 foods, Income requirements, and       provided. i.e. referrals, nutrition
                 Community resources.                  education, community resources,
                                                       nutritious foods, WIC complaint
                                                       hotline, and other basic information.
                   Participants’ rights and            Explains to participants their rights
                   responsibilities                    and responsibilities and voter
                                                       registration
                   How to use WIC Food Instruments     How to use Food Instruments and
                                                       Cash Value Vouchers and where they
                                                       can be used.
                   How to complete and use WIC ID
                                                       Accurately completes and explains the
                   folder
                                                       WIC ID folder

                   The basic physiology of lactation   Promotes breastfeeding.
                   and evidence-based techniques for   Explains WIC support and resources
                   lactation management.               available to participants such as the
                   Breastfeeding support and           breastfeeding hotline, as appropriate
                   resources provided by WIC.
                                                       Provide appropriate referrals to
                   Community Referral Resources

ARIZONA WIC PROGRAM                                                                                        ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education

Competency           Knowledge and Skills                Performance Expected                    Target   Comments     Date
Revised 8.25.09                                                                                  Date                  Completed
                                                         community resources.

                                                         Attends required in-services and
                                                         trainings.

                                                         Successful completion of required CS
                                                         courses.
2. Nutrition         Knowledge of:
assessment                                               Pre-certifies and schedules WIC
process:             How to navigate in AIM              appointments in AIM
Understands the
WIC nutrition        WIC eligibility and certification   Explains eligibility requirements and
assessment           requirements.                       certification process to participants
process, including
risk assignment      Knowledge and purpose of            Accurately completes the following
and                  nutrition assessment, risk          using AIM: collect required
documentation.       assignment, nutrients in WIC        demographic data, eligibility and
                     foods, and food package in the      category determination, record
                     WIC program                         documentation, food instrument
                                                         issuance, appointment scheduling,
                                                         and referrals to other programs

                                                         Documents referrals made in AIM.
                     Importance of accurately
                     documenting in AIM.                 Determines which other community
                                                         programs the participant may be
                     Other available services in the     eligible for and/or may benefit from
                     community.                          and makes appropriate referrals.

                                                         Successful completion of CS required
                                                         courses.


ARIZONA WIC PROGRAM                                                                                       ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                               REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education

Competency          Knowledge and Skills                 Performance Expected                     Target   Comments     Date
Revised 8.25.09                                                                                   Date                  Completed
3. Anthropometric   Knowledge of:
and hematological
data collection     Knowledge and purpose of             Cleans, maintains, sets up, and
techniques:         medical assessment in the WIC        organizes the laboratory to meet local
Understands the     program and how to collect           and state quality assurance
importance of       hematological and anthropometric     standards.
using appropriate   information.
measurement
techniques to
collect             The basic relevance of               Demonstrates appropriate
anthropometric      anthropometric data to health and    anthropometric measurement
and hematological   nutrition status.                    techniques.
data.               Relationship of hematological        Reads and records measurements
                    parameters to health and nutrition   accurately.
                    status
                                                         Demonstrates appropriate technique
                                                         for performing a hemoglobin
                                                         screening and assessment.

                                                         Obtains consent and release prior to
                                                         performing screenings.

                                                         Conducts health assessments to
                                                         include measurements of stature,
                                                         weight, hemoglobin, and review of
                                                         medical documentation.

                                                         Explains the purpose of collecting
                                                         anthropometric and hematological
                                                         data to participants.

                                                         Follows protocols for re-

ARIZONA WIC PROGRAM                                                                                        ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education

Competency          Knowledge and Skills                 Performance Expected                      Target   Comments     Date
Revised 8.25.09                                                                                    Date                  Completed
                                                         measurements.

                                                         Successful completion of required CS
                                                         courses.
4.                  Knowledge of:
Communication:
Knows how to        The principles of effective          Answers, routes, and receives all
develop rapport     communication                        incoming phone calls for clinic(s)
and foster open
communication                                            Documents participant demographic
with participants                                        information
and caretakers.
                                                         Picks up and delivers mail, receives
                                                         and distributes correspondence

                                                         Monitors and orders office and
                                                         medical supplies as needed

                                                         Documents food instrument issuance
                    USDA and State agency policies
                                                         Obtains release of information before
                    about participant confidentiality.
                                                         sharing any participant data

                                                         Protects participant confidentiality in
                                                         conversations with others

                                                         Conducts interviews and collects
                                                         information on residency, income, and
                                                         family situation.

                                                         Provides education to participants on
                                                         program rights and responsibilities,

ARIZONA WIC PROGRAM                                                                                         ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                 REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education

Competency             Knowledge and Skills                   Performance Expected                      Target   Comments     Date
Revised 8.25.09                                                                                         Date                  Completed
                                                              how to use food instruments correctly,
                                                              and WIC foods.

                                                              Provides explanations when/if
                                                              participant is unable to follow program
                                                              guidelines.

                                                              Answers basic questions and resolves
                                                              simple complaints from applicants.

                                                              Successful completion of required CS
                                                              courses.


5. Multicultural       Knowledge of:                          Completes annual Civil Rights training
awareness:
Understands how        Cultural groups in the target          Respects different belief systems
sociocultural          population, including their families   about issues such as blood work,
issues affect          and communities, values and            alternative medicine, and traditional
nutrition and health   beliefs, characteristics, and          healers.
practices and          resources.
nutrition-related
health problems.       Cultural eating patterns and family    Uses culturally appropriate
                       traditions such as core foods,         communication styles to collect
                       traditional celebrations, and          participant information
                       fasting.
                                                              Uses interpretation and/or translation
                       Differences in communication           services appropriately to collect
                       styles between groups and how          information from participants with
                       these differences may impact the       limited English proficiency.
                       assessment process.
                                                              Awareness of cultural issues

ARIZONA WIC PROGRAM                                                                                              ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                      REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education

Competency              Knowledge and Skills                Performance Expected                         Target   Comments     Date
Revised 8.25.09                                                                                          Date                  Completed
                                                            surrounding breastfeeding.


6. Critical thinking:   Knowledge of:
Knows how to
synthesize and          Principles of critical thinking.    Schedules participants appropriately.
analyze data to
draw appropriate        Critical thinking recognizes when   Asks additional questions to clarify
conclusions.            participants need higher level      information or gather more details.
                        referrals such as nutritionists,
                        supervisors, and/or IBCLC.          Maintains an awareness of the
                                                            participant’s current situation and
                                                            determines best course of action.

                                                            Makes appropriate referrals to
                                                            supervisors, dietitians, or IBCLC.

7. Customer             Knowledge of:
Services: Provides
good customer           Principles of PCE in dealing with   Greets and acknowledges customers
service using PCE       customers to meet their needs.      in courteous manner builds rapport
approach.                                                   with active and reflective listening.

                                                            Provides accurate and relevant
                                                            information.

                                                            Able to diffuse a difficult situation with
                                                            a frustrated/angry customer




ARIZONA WIC PROGRAM                                                                                               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                       REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education

                                                 Nutrition Education Specialist
 Minimum requirements: Bachelors Degree in Nutrition or DTR certification or Associates degree plus 12 hours of college level nutrition
    courses or Certification Specialist plus 12 hours of college level nutrition courses – Recommended for FY10; Mandatory for FY13
Revised 8.25.09
Competency            Knowledge and Skills                             Performance Expected           Target  Comments Date
                                                                                                      Date                Completed
1. Principles of      In addition to knowledge and skills of the       In addition to performance
life-cycle nutrition: CS.                                              expected of CS:
Understands           Knowledge of:
normal nutrition                                                       Analyzes health and nutrition
issues for            Nutrition requirements and dietary               histories based on lifecycle
pregnancy,            recommendations for women, infants, and          stage. Evaluates the impact
lactation, the        children served by WIC.                          of the parent/feeding
postpartum                                                             dynamics on nutritional
period, infancy,                                                       status, growth, and
and early                                                              development.
childhood.
                      Federal nutrition policy guidance and its        Interprets and compares
                      implications for women, infants and children dietary practices of WIC
                      served by WIC.                                   participants to federal policy
                                                                       guidance.

                                                                   Differentiates between safe
                                                                   and inappropriate food and
                                                                   nutrition practices.

                                                                   Selects food package tailored
                                                                   to participant’s nutritional and
                                                                   preference needs.

                                                                   Selects appropriate nutrition
                                                                   education materials
                    Relevant evidence-based recommendations

ARIZONA WIC PROGRAM                                                                                         ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                 REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education

Revised 8.25.09
Competency        Knowledge and Skills                          Performance Expected             Target   Comments     Date
                                                                                                 Date                  Completed
                  published by the American Academy of
                  Pediatrics, the American Dietetic             Analyzes and compares
                  Association, American College of Obstetrics   dietary practices to evidence-
                  and Gynecology, and the International         based recommendations.
                  Lactation Consultant Association.
                                                                Assesses potential barriers to
                                                                breastfeeding.

                                                                Recognizes health and
                                                                lifestyle contraindications to
                                                                breastfeeding.


                                                                Applies knowledge of
                                                                physiology in the assessment
                  The basic physiology of lactation and         of breastfeeding problems.
                  evidence-based techniques for lactation
                  management.                                   Successfully completes the
                                                                Certified Breastfeeding
                                                                Course(CBC) and/or Certified
                                                                Lactation Course (CLC).

                                                                After passing the CBC/CLC
                                                                courses, completes
                                                                breastfeeding assessments at
                                                                critical points in the early
                                                                postpartum period.

                                                                Analyzes breastfeeding
                                                                problems using evidence-


ARIZONA WIC PROGRAM                                                                                       ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                               REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education

Revised 8.25.09
Competency           Knowledge and Skills                       Performance Expected               Target   Comments     Date
                                                                                                   Date                  Completed
                                                                based information as the
                                                                standard. Evaluates the
                                                                impact of early formula
                                                                supplementation and
                                                                mother/infant separation on
                                                                milk supply and the mother’s
                                                                breastfeeding intention.

                                                                Promotes breastfeeding and
                                                                refers participants to Certified
                                                                Lactation Consultants as
                                                                needed.

                                                                Attends the state-wide
                                                                nutrition education workshop,
                                                                regional training,
                                                                departmental in-services, and
                                                                other trainings as required.

2. Nutrition         Knowledge of:
assessment
process:             How to conduct an effective assessment     Complete in AIM: health
Understands the      using the AIM system and VENA skills.      history and nutrition
WIC nutrition                                                   questionnaire screens
assessment                                                      utilizing probing questions.
process, including
risk assignment      WIC medical and nutrition risk criteria.   Evaluates need for
and                                                             documentation of diagnosis
documentation.                                                  vs. self-report of medical
                                                                conditions according to


ARIZONA WIC PROGRAM                                                                                         ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                 REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education

Revised 8.25.09
Competency         Knowledge and Skills                         Performance Expected              Target   Comments     Date
                                                                                                  Date                  Completed
                                                                policies.

                                                                Applies risk definitions
                                                                correctly and uses
                                                                appropriate cut-off values
                                                                when assigning nutrition risks.

                                                                Communicates risk to
                   Importance of documenting nutrition          participant using PCE skills.
                   assessment results.
                                                                Documents accurately in AIM.

                                                                Assess participant progress
                                                                from previous visit.
3. Anthropometric Knowledge of:
and hematological
data collection   Relevance of anthropometric data to health    Interprets growth data and
techniques:       and nutrition status.                         prenatal weight gains
Understands the                                                 correctly.
importance of
using appropriate
measurement                                                     Evaluates anthropometric and
techniques to                                                   blood work results for
collect                                                         nutritional risk.
anthropometric
and hematological                                               Follow local agency protocol
data.                                                           for values that qualify as a
                                                                medical emergency.
                  Relationship of hematological parameters to
                  health and nutrition status

ARIZONA WIC PROGRAM                                                                                        ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education

Revised 8.25.09
Competency           Knowledge and Skills                         Performance Expected               Target   Comments     Date
                                                                                                     Date                  Completed
4. Nutrition         Knowledge of:
Education:                                                        Provides participant centered
Provide              PCE skills including motivational            nutrition education based on
Participant          interviewing and emotion based counseling.   participant interest and risk to
Centered nutrition                                                achieve behavior change.
education.
                     Nutrition Care Standards. (Care Plans)       Provides evidence –based
                                                                  nutrition education based on
                                                                  participant interest and risk.
                     WIC approved education materials such as     Use handouts when
                     Touching Hearts, Touching Minds and          appropriate.
                     Breastfeeding book.
                                                                  Documents nutrition
                                                                  education given in care plan
                                                                  appropriately.
                     Other available services in the community.   Documents referrals
                                                                  provided.

                                                                  Determines which other
                                                                  community programs the
                                                                  participant may be eligible for
                                                                  and/or may benefit from and
                                                                  makes appropriate referrals
                                                                  and documentation.
5. Behavior          Knowledge of:                                Assesses participants’
Change: Help                                                      readiness for change.
guide participant    Behavioral change theories such as stages
to identify          of change.                                   Works with participants to


ARIZONA WIC PROGRAM                                                                                           ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                   REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education

Revised 8.25.09
Competency            Knowledge and Skills                           Performance Expected            Target   Comments     Date
                                                                                                     Date                  Completed
behavior change                                                      determine next steps.
goals.
                                                                     Conducts PCE group
                                                                     sessions and discussions.

                                                                     Documents participants’ goals
                                                                     in AIM.

6. Food Package       Knowledge of:
Assignment:                                                          Assigns issues and
Tailor food           WIC Food Packages available in AIM.            documents appropriate food
package to meet                                                      package in AIM.
participant health,   WIC formula and food package issuance          Able to customize a food
situational and       policies and procedures.                       package in AIM.
cultural needs.
                                                                     Follows procedure for new
                                                                     food package request.
7.
Communication:        The principles of effective communication to
Knows how to          collect nutrition assessment information.
develop rapport                                                      Provides PCE based on
and foster open                                                      participant’s identified
communication                                                        nutritional risk and the
with participants                                                    participant’s priority,
and caretakers.                                                      emphasizing positive health
                                                                     outcomes.


                                                                     Answers more complex
                                                                     questions and resolves more


ARIZONA WIC PROGRAM                                                                                           ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                   REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education

Revised 8.25.09
Competency         Knowledge and Skills                             Performance Expected              Target   Comments     Date
                                                                                                      Date                  Completed
                                                                    complex complaints from
                                                                    applicants.

                                                                    Acts as mentor to Certification
                                                                    Specialist.




8. Multicultural   Knowledge of:
awareness:
Understands how    Cultural groups in the target population,        Respects different belief
socio-cultural     including their families and communities,        systems about issues such as
issues affect      values and beliefs, characteristics, and         blood work, immunizations,
nutrition and      resources.                                       dietary supplements,
health practices                                                    alternative medicine, and
and nutrition-                                                      traditional healers.
related health
problems.                                                           Evaluates cultural practices
                                                                    for their potential to harm the
                                                                    participant’s health or
                                                                    nutritional status.
                   Cultural eating patterns and family traditions   When appropriate, includes
                   such as core foods, traditional celebrations,    core foods and recognizes
                   and fasting.                                     their nutrient contributions in
                                                                    an assessment of eating
                                                                    patterns.


ARIZONA WIC PROGRAM                                                                                            ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                    REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education

Revised 8.25.09
Competency          Knowledge and Skills                       Performance Expected               Target   Comments     Date
                                                                                                  Date                  Completed
                                                               Evaluates food selection and
                                                               preparation within a cultural
                                                               context.

                                                               Selects food package tailored
                    Differences in communication styles        to participant’s cultural needs.
                    between groups and how these differences
                    may impact the assessment process.         Uses culturally appropriate
                                                               communication styles to
                                                               collect nutrition assessment
                                                               information.

                                                               Uses interpretation and/or
                                                               translation services
                                                               appropriately to collect
                                                               nutrition assessment
                                                               information from participants
                                                               with limited English
                                                               proficiency.

                                                               Uses culturally appropriate
                                                               strategies to assess
                                                               breastfeeding practices and
                                                               beliefs
9. Critical         Knowledge of:
thinking: Knows
how to synthesize   Principles of critical thinking.           Collects all assessment
and analyze data                                               information before drawing
to draw                                                        risk or counseling conclusions
appropriate                                                    and deciding upon the best


ARIZONA WIC PROGRAM                                                                                        ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education

Revised 8.25.09
Competency        Knowledge and Skills          Performance Expected             Target   Comments     Date
                                                                                 Date                  Completed
conclusions.                                    course of action.

                                                Asks additional probing
                                                questions to clarify
                                                information or gather more
                                                details.

                                                Recognizes factors that
                                                contribute to the identified
                                                nutrition problem(s) and
                                                refers appropriately.

                                                Considers the applicant’s
                                                point of view about nutrition
                                                and health priorities, needs,
                                                and concerns.

                                                Prioritizes nutrition problems
                                                to be addressed.

                                                Understands when to refer
                                                participant to the
                                                nutritionist/RD"




ARIZONA WIC PROGRAM                                                                       ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                               REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education


                        WIC Program Quality Assurance Activities Performed by Manager or Designee

Revised 7.30.09
Competency         Knowledge and Skills                    Performance Expected        Target   Comments     Date
                                                                                       Date                  Completed
1. Principles of   Same knowledge and skills as NES.       Same performance expected
life-cycle                                                 as NES.
nutrition:
Understands
normal nutrition
issues for
pregnancy,
lactation, the
postpartum
period, infancy,
and early
childhood.


2. Nutrition       Same knowledge and skills as NES.       Same performance expected
assessment                                                 as NES.
process:
Understands the
WIC nutrition
assessment
process,
including risk
assignment and
documentation.




ARIZONA WIC PROGRAM                                                                             ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                     REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education

Revised 7.30.09
Competency          Knowledge and Skills                           Performance Expected               Target   Comments     Date
                                                                                                      Date                  Completed
3.                  In addition to the Knowledge and Skills of
Anthropometric      NES:
and                                                                Conducts quality assurance
hematological       State Anthropometric and Laboratory manual     activities on laboratory results
data collection     regarding lab techniques, quality assurance,   and record keeping
techniques:         and record keeping.                            procedures.
Understands the
importance of
using appropriate
measurement
techniques to
collect
anthropometric
and
hematological
data.
4. Nutrition        Same Knowledge and Skills as NES.              Same Performance Expected
Education:                                                         of NES.
Provide
Participant
Centered
nutrition
education.
5. Behavior         In addition to Knowledge and Skills as NES:    In addition to Performance
Change: Help                                                       Expected of NES:
guide client to     Knowledge of adult learning principles and
identify behavior   behavior change theory.                        Assist staff in their own work
change goals.                                                      performance improvement.

6. Food Package     In addition to Knowledge and Skills as NES:    In addition to Performance

ARIZONA WIC PROGRAM                                                                                            ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                    REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education

Revised 7.30.09
Competency           Knowledge and Skills                          Performance Expected                Target   Comments     Date
                                                                                                       Date                  Completed
Assignment:                                                        Expected of NES:
Tailor food
package to meet      AIM reports related to food package           Run and analyze food
client health,       issuance.                                     package reports in AIM and
situational and                                                    take appropriate action to
cultural needs.                                                    resolve any discrepancies.

                                                                   Work with and respond to
                     State and local policies and procedures       vendors, medical community,
                     related to food packages                      and other external partners
                                                                   regarding food package
                                                                   guidelines.
                                                                   Follows procedure for new
                                                                   food package request.
7.                   In addition to Knowledge and Skills NES:      In addition to Performance
Communication:                                                     Expected of NES:
Knows how to
develop rapport      Knowledge of customer service and conflict    Provide effective and timely
and foster open      management principles.                        resolution of conflict to satisfy
communication                                                      client need.
with participants,
caretakers, staff,                                                 Ensure that clients receive
and external                                                       good customer service
partners.                                                          through observation and
                                                                   client feedback.
                     Knowledge of effective verbal and written
                     communication skills.                         Speaks and writes clearly and
                                                                   effectively.

8. Multicultural     In addition to Knowledge and Skills of NES:   In addition to Performance


ARIZONA WIC PROGRAM                                                                                             ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                     REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education

Revised 7.30.09
Competency         Knowledge and Skills                          Performance Expected               Target   Comments     Date
                                                                                                    Date                  Completed
awareness:                                                       Expected of NES:
Understands how
socio-cultural     Knowledge of Civil Rights Title VI law        Ensures that clients’ language
issues affect      regarding language access services.           needs are met.
nutrition and
health practices
and nutrition-
related health
problems.
9. Critical        In addition to Knowledge and Skills of NES:   In addition to Performance
thinking: Knows                                                  Expected of NES:
how to             Principles of critical thinking.
synthesize and                                                   Demonstrates a strong ability
analyze data to                                                  to identify, analyze, and solve
draw appropriate                                                 problems.
conclusions.
10. Clinic         Knowledge and Skills of:
Operations:
Knowledge of       Federal, State, and Local policies and        Follows Federal, State, and
how to maintain    procedures.                                   Local policies and
processes                                                        procedures.
necessary for
clinic function                                                  Develop clinic procedures for
and integrity.                                                   policy implementation.
                   Caseload management.                          Maintains and optimizes
                                                                 caseload via staffing patterns,
                                                                 clinic flow, staff productivity,
                                                                 outreach, budget
                                                                 management, and quality

ARIZONA WIC PROGRAM                                                                                          ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                  REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education

Revised 7.30.09
Competency           Knowledge and Skills                            Performance Expected             Target   Comments     Date
                                                                                                      Date                  Completed
                                                                     customer service.
                     AIM reports and Discover queries.
                                                                     Runs, analyzes, and/or
                                                                     addresses pertinent reports.
                     Fraud and integrity policies and corrective
                     actions.                                        Runs, analyzes, and/or
                                                                     addresses pertinent reports.

                                                                     Follows State and Local
                                                                     procedures in handling client
                                                                     and staff fraud.
                     Community partners and resources.
                                                                     Performs check reconciliation.

                                                                     Develops and maintains
                     Emergency, OSHA, State, and Local security      referral network and referral
                     policies on staff, clinic, and client safety.   materials.

                                                                     Follows policies to maintain a
                                                                     safe environment and reports
                                                                     issues appropriately.
11. Personnel        Knowledge of and skills related to:
Management:
Knowledge of         Management and supervisory principles.          Makes certain that employees
how to effectively                                                   have a clear understanding of
manage staff.                                                        their responsibilities.

                                                                     Effectively coaches and
                                                                     counsels staff.

                                                                     Motivates staff to work toward

ARIZONA WIC PROGRAM                                                                                            ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                    REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education

Revised 7.30.09
Competency        Knowledge and Skills                     Performance Expected              Target   Comments     Date
                                                                                             Date                  Completed
                                                           personal, professional, and
                                                           agency goals.

                                                           Monitors, mentors, and
                                                           coaches staff to ensure
                                                           compliance with Federal,
                                                           State, and Local policies and
                                                           utilizes appropriate monitoring
                                                           tools.

                                                           Prepares staff for
                                                           Management Evaluations.


                                                           Provides a safe environment
                                                           for mentoring, coaching, and
                                                           providing feedback to staff.

                                                           Evaluates participant
                  Training requirements of staff.          centeredness of clinic.

                                                           Develop and monitor
                                                           adherence to training plans
                                                           for all staff utilizing
                                                           appropriate training
                  Local agency human resources/personnel   resources, i.e. LMS and in-
                  rules.                                   person trainings.

                                                           Follows local guidelines on
                                                           hiring, firing, and progressive


ARIZONA WIC PROGRAM                                                                                   ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                           REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education

Revised 7.30.09
Competency        Knowledge and Skills          Performance Expected          Target   Comments     Date
                                                                              Date                  Completed
                                                discipline.

                                                Uses sound coaching
                                                techniques to solve
                                                disciplinary problems.

                                                Conducts regular
                                                performance evaluations for
                                                each staff.




ARIZONA WIC PROGRAM                                                                    ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                            REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education


                                                      High Risk Nutritionist

Competency         Knowledge and Skills                           Performance Expected               Target   Comments     Date
                   In addition to knowledge and skills of         In addition to performance         Date                  Completed
                   Certification Specialist (CS) and Nutrition    expected on Certification
                   Education Specialist (NES) and Medium          Specialist (CS) and Nutrition
                   Risk Nutritionist, knowledge of:               Education Specialist (NES)
                                                                  and Medium Risk Nutritionist:

1. Principles of   Nutrition requirements and dietary             Provides nutrition education
life-cycle         recommendations for women, infants, and        to high-risk participants
nutrition:         children served by WIC.                        High Risks:
Understands                                                       103- infants and children
normal nutrition   Federal nutrition policy guidance and its      underweight <5%ile
issues for         implications for women, infants and children   132 – maternal weight loss
pregnancy,         served by WIC.                                 134- failure to thrive – infants
lactation, the                                                    and children
postpartum                                                        141- low birth weight infants
period, infancy,                                                  and children up to 12 months
and early                                                         142- premature infants and
childhood.                                                        children up to 12 months
                                                                  302- gestational diabetes for
                                                                  pregnant women, referral to
                                                                  MNT or doctor
                                                                  602/603 – Breast Feeding
                                                                  complications; after initial
                                                                  consultation may be referred
                                                                  to CBC or CLC

                                                                  Approves special formula
                                                                  food packages
2. Nutrition       Knowledge of:                                  Monitor high-risk client

ARIZONA WIC PROGRAM                                                                                           ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                   REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education

Competency          Knowledge and Skills                          Performance Expected             Target   Comments     Date
                    In addition to knowledge and skills of        In addition to performance       Date                  Completed
                    Certification Specialist (CS) and Nutrition   expected on Certification
                    Education Specialist (NES) and Medium         Specialist (CS) and Nutrition
                    Risk Nutritionist, knowledge of:              Education Specialist (NES)
                                                                  and Medium Risk Nutritionist:

assessment                                                        progress.
process:            Purpose of nutrition assessment in the WIC
Understands the     program and how to collect information.       Writes nutrition education and
WIC nutrition                                                     nutrition risk protocols with
assessment          WIC nutrition risk criteria.                  local agency
process,
including risk                                                    Successfully completes LMS
assignment and                                                    courses as they become
documentation.                                                    available.
3.                                                                Read and reference
Anthropometric                                                    Anthropometric Lab manual
and
hematological
data collection
techniques:
Understands the
importance of
using appropriate
measurement
techniques to
collect
anthropometric &
hematological
data.
4.                  Knowledge of:
Communication:

ARIZONA WIC PROGRAM                                                                                         ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                 REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education

Competency          Knowledge and Skills                           Performance Expected            Target   Comments     Date
                    In addition to knowledge and skills of         In addition to performance      Date                  Completed
                    Certification Specialist (CS) and Nutrition    expected on Certification
                    Education Specialist (NES) and Medium          Specialist (CS) and Nutrition
                    Risk Nutritionist, knowledge of:               Education Specialist (NES)
                                                                   and Medium Risk Nutritionist:

Knows how to        The principles of effective communication to   Answers the most complex
develop rapport     collect nutrition assessment information.      questions and resolves the
and foster open                                                    most complex complaints
communication                                                      from applicants.
with participants   USDA and State agency policies about
and caretakers.     participant confidentiality.

5. Multicultural
awareness:
Understands how
socio-cultural
issues affect
nutrition and
health practices
and nutrition-
related health
problems.


6. Critical
thinking: Knows
how to
synthesize and
analyze data to
draw appropriate
conclusions.

ARIZONA WIC PROGRAM                                                                                         ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                 REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education

Competency       Knowledge and Skills                           Performance Expected              Target   Comments     Date
                 In addition to knowledge and skills of         In addition to performance        Date                  Completed
                 Certification Specialist (CS) and Nutrition    expected on Certification
                 Education Specialist (NES) and Medium          Specialist (CS) and Nutrition
                 Risk Nutritionist, knowledge of:               Education Specialist (NES)
                                                                and Medium Risk Nutritionist:


7. Manages and   Federal nutrition policy guidance and its      Acts as a liaison to public and
supervises WIC   implications for women, infants and children   government agencies, health
staff            served in WIC                                  care providers, and hospitals
                                                                regarding nutrition and
                                                                program service issues

                                                                Participates in the
                                                                development of policies and
                                                                procedures
                                                                Oversees and assists the
                                                                director in developing training
                                                                plan for CNW’s in area of
                                                                nutrition

                                                                Acts as preceptor/proctor for
                                                                staff training.

                                                                Manages and monitors
                                                                employee activities in LMS

                                                                Participates in hiring process
                                                                for other CNW’s

                                                                Participates in supervising
                                                                and training staff


ARIZONA WIC PROGRAM                                                                                        ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education

Competency      Knowledge and Skills                          Performance Expected             Target   Comments     Date
                In addition to knowledge and skills of        In addition to performance       Date                  Completed
                Certification Specialist (CS) and Nutrition   expected on Certification
                Education Specialist (NES) and Medium         Specialist (CS) and Nutrition
                Risk Nutritionist, knowledge of:              Education Specialist (NES)
                                                              and Medium Risk Nutritionist:


                                                              Assists in planning and
                                                              coordinating outreach efforts,
                                                              and/or other WIC related
                                                              programs or projects

                                                              Conducts staff meetings and
                                                              in-services.

                                                              Other duties as assigned.




ARIZONA WIC PROGRAM                                                                                     ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                             REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education


                                                    Medium Risk Nutritionist

Competency         Knowledge and Skills                          Performance Expected             Target   Comments     Date
Revised 8/17/09    In addition to Knowledge and Skills of        In addition to performance       Date                  Completed
                   Certification Specialist (CS) and Nutrition   expected of Certification
                   Education Specialist (NES):                   Specialist (CS) and Nutrition
                                                                 Education Specialist ( NES):

1. Principles of   Knowledge of:                                 Provides nutrition education
life-cycle                                                       to medium-risk participants
nutrition:         Nutrition requirements, dietary               and tailors food packages
Understands        recommendations, and Federal nutrition        appropriately.
normal nutrition   policy guidance for women, infants, and       Medium Risks:
issues for         children served by WIC.                       101 - pre--pregnancy
pregnancy,                                                       underwgt.
lactation, the                                                   103- infants and children
postpartum                                                       underwgt >5%ile - <10 %ile
period, infancy,                                                 131- low maternal wgt. gain
and early                                                        141- low birth wgt.infants and
childhood.                                                       children, previously seen by
                                                                 high risk nutritionist, when
                                                                 infants are older than 12
                                                                 months
                                                                 142- premature infants and
                                                                 children, previously seen by
                                                                 high risk nutritionist, when
                                                                 infants older than 12 months
                                                                 201- anemia, when
                                                                 hemoglobin in the
                                                                 ―nutritionist‖ ranges

2. Nutrition       In addition to Knowledge and Skills of NES:   In addition to Performance

ARIZONA WIC PROGRAM                                                                                        ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education

Competency          Knowledge and Skills                             Performance Expected             Target   Comments     Date
Revised 8/17/09     In addition to Knowledge and Skills of           In addition to performance       Date                  Completed
                    Certification Specialist (CS) and Nutrition      expected of Certification
                    Education Specialist (NES):                      Specialist (CS) and Nutrition
                                                                     Education Specialist ( NES):

assessment          Knowledge of:                                    Expected on NES:
process:
Understands the     Purpose of nutrition assessment in the WIC       Provides a thorough
WIC nutrition       program and how to collect information.          assessment of medium-risk
assessment                                                           clients before providing
process,            WIC nutrition risk criteria.                     education/intervention.
including risk
assignment and                                                       Monitors medium-risk client
documentation.                                                       progress.

                                                                     Writes nutrition education and
                                                                     nutrition risk protocols with
                                                                     local agency and receives
                                                                     approval from the State.


3.                  In addition to the Knowledge and Skills of the
Anthropometric      NES:
and
hematological       Knowledge of State Anthropometric and            Assists supervisor in staff
data collection     Laboratory manual regarding lab techniques,      observation.
techniques:         quality assurance, and record keeping.
Understands the
importance of
using appropriate
measurement
techniques to


ARIZONA WIC PROGRAM                                                                                            ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                    REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education

Competency          Knowledge and Skills                            Performance Expected              Target   Comments     Date
Revised 8/17/09     In addition to Knowledge and Skills of          In addition to performance        Date                  Completed
                    Certification Specialist (CS) and Nutrition     expected of Certification
                    Education Specialist (NES):                     Specialist (CS) and Nutrition
                                                                    Education Specialist ( NES):

collect
anthropometric &
hematological
data.

4. Nutrition        In addition to the Knowledge and Skills of      In addition to Performance
Education:          NES:                                            Expected of NES:
Provide
Participant                                                         Serves as model for all staff
Centered            Advanced knowledge of participant centered      of exemplary participant
nutrition           education and adult learning principles,        centered education.
education.          including motivational interviewing, emotion-
                    based counseling, and behavior change           Mentors NES and Supervisor
                    theory.                                         staff in PCE techniques and
                                                                    provides constructive
                                                                    feedback and evaluation.
5. Behavior         In addition to Knowledge and Skills as NES:     In addition to Performance
Change: Help                                                        Expected of NES:
guide client to
identify behavior   Knowledge of adult learning principles and      Helps medium-risk clients
change goals.       behavior change theory.                         move toward behavior
                                                                    change and monitors their
                                                                    progress.

                                                                    Assists staff in their own work
                                                                    performance improvement.
6. Food Package     In addition to Knowledge and Skills as NES:     In addition to Performance


ARIZONA WIC PROGRAM                                                                                            ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                    REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education

Competency        Knowledge and Skills                          Performance Expected            Target   Comments     Date
Revised 8/17/09   In addition to Knowledge and Skills of        In addition to performance      Date                  Completed
                  Certification Specialist (CS) and Nutrition   expected of Certification
                  Education Specialist (NES):                   Specialist (CS) and Nutrition
                                                                Education Specialist ( NES):

Assignment:                                                     Expected of NES:
Tailor food       Knowledge of:
package to meet
client health,    Food package policies, procedures, and        Assesses clients’ need for
situational and   availability in AIM to assign appropriate     and approves special formula
cultural needs.   package to participants.                      food packages.

                                                                Follows up with physicians on
                                                                non-contract regular formulas
                                                                and requests approval from
                                                                State.

                                                                Assists clients in obtaining
                                                                special formulas.

                                                                Works with and responds to
                                                                vendors, medical community,
                                                                and other external partners
                                                                regarding food package
                                                                guidelines.

                                                                Follows procedure for new
                                                                food package request.
                  Federal Food Package III and importance of
                  working with health care providers.           Coordinates with local health
                                                                care providers to obtain
                                                                necessary documentation and


ARIZONA WIC PROGRAM                                                                                      ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                              REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education

Competency           Knowledge and Skills                           Performance Expected              Target   Comments     Date
Revised 8/17/09      In addition to Knowledge and Skills of         In addition to performance        Date                  Completed
                     Certification Specialist (CS) and Nutrition    expected of Certification
                     Education Specialist (NES):                    Specialist (CS) and Nutrition
                                                                    Education Specialist ( NES):

                                                                    provide appropriate food and
                     All WIC-approved formulas and indications,     formulas to clients.
                     including formulas for special needs clients
                     and medical foods.                             Approves appropriate
                                                                    formulas and medical foods
                                                                    and follows up with health
                     Policies regarding working with AHCCCS         care provider when needed.
                     and CRS.
                                                                    Coordinates and refers with
                                                                    AHCCCS and CRS per State
                                                                    protocol.
7.                   In addition to Knowledge and Skills of NES:    In addition to Performance
Communication:                                                      Expected of NES:
Knows how to
develop rapport      Knowledge of customer service and conflict     Models excellent customer
and foster open      management principles.                         service.
communication
with participants,
caretakers, staff,   Knowledge of effective verbal and written      Models exemplary verbal and
and external         communication skills.                          written communication skills.
partners.
8. Critical          In addition to Knowledge and Skills of NES:    In addition to Performance
thinking: Knows                                                     Expected of NES:
how to
synthesize and       Knowledge of appropriate case management       Utilizes community resources
analyze data to      and advocacy skills to achieve optimal         and referrals to best serve the
draw appropriate     outcomes.                                      client’s needs.

ARIZONA WIC PROGRAM                                                                                            ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                    REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education

Competency        Knowledge and Skills                          Performance Expected             Target   Comments     Date
Revised 8/17/09   In addition to Knowledge and Skills of        In addition to performance       Date                  Completed
                  Certification Specialist (CS) and Nutrition   expected of Certification
                  Education Specialist (NES):                   Specialist (CS) and Nutrition
                                                                Education Specialist ( NES):

conclusions.

7. Mentoring,     Knowledge of VENA, PCE, nutrition, and        Mentors, models, and trains
Monitoring, and   adult learning principles.                    all staff on nutrition-related
Training                                                        topics.

                                                                Works one-on-one with staff
                                                                to develop PCE skills.
                  Knowledge of Federal, State, and Local
                  policies and procedures.                      Assists supervisor in
                                                                observation of staff to comply
                                                                with policies and to prepare
                                                                for management evaluations.

                                                                Assists in the hiring process
                                                                and training of new staff.




ARIZONA WIC PROGRAM                                                                                       ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                               REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education


                                                 General Core Competency Training Schedule

     Core                    Role           Possible           Start    Proposed          Methodology/Source           Evaluation           Hours
  Competencies                             Resources           Date    Completion                                                        Required to
                                                                          Date                                                          learn material
  WIC Program             All Staff     Civil Rights          Week 1   Week 4 (Civil      Introduction to WIC and     Introduction to
                                                                       Rights)            Civil Rights LMS courses;   WIC Final Exam
                                        Introduction to WIC            Week 6             Introduction to WIC         Introduction to
                                                                       (Introduction to   Competency Checklist        WIC
                                                                       WIC)               (LMS) - completed by        Competency
                                                                                          designated local agency     Checklist
                                                                                          trainer.                    Other-local
                                                                                          Individual instruction by   agency specific
                                                                                          Lead Trainer or designee    evaluation
                                                                                          and hands-on practice
  AIM 101 –Getting        CS/NES/       AIM 101 - LMS         Week 1   Week 6             AIM 101 LMS Course and      AIM 101 Final
  Started, Appt           Supervisor/                                                     Competency Checklist        Exam
  scheduling, Pre-        RD (Peer                                                                                    and Competency
  Certs                   Counselor                                                                                   Checklist
                          Optional)
  AIM 102-                CS/NES/       AIM 102 – LMS         Week 2   Week 6             AIM 102 LMS Course and      AIM 102 Final
  Certification, Client   Supervisor/                                                     Competency Checklist        Exam
  Reg, Medical,           RD                                                                                          and Competency
  Overview of the                                                                                                     Checklist
  rest of the
  process; Printing
  forms
  AIM 103 –               NES/          AIM 103 - LMS         Week 3   Week 8             AIM 103 LMS Course and      AIM 103 Final
  Overview of cert        Supervisor/                                                     Competency Checklist        Exam
  process; health         RD                                                                                          and Competency
  history; Nutrition                                                                                                  Checklist
  education screen;
  care plan; nutrition
  education; medical
  referrals; food
  package
  AIM 104 –               CS/NES/       AIM 104 – LMS         Week 4   Week 12            AIM 104 LMS Course and      AIM 104 Final


ARIZONA WIC PROGRAM                                                                                                          ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                                  REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education

     Core                Role            Possible           Start     Proposed    Methodology/Source           Evaluation            Hours
  Competencies                          Resources           Date     Completion                                                   Required to
                                                                        Date                                                     learn material
  Additional AIM       Supervisor/                                                Competency Checklist        Exam
  Functions            RD                                                                                     and Competency
                                                                                                              Checklist
  Nutrition and Risk   NES/          Nutrition and Risk    Week 3    Week 8       Nutrition and Risk          Nutrition and
  Assessment           Supervisor/   Assessment LMS                               Assessment Course and       Risk
                       RD            Course (TBD)                                 Competency Checklist        Assessment
                                                                                                              Final Exam and
                                     Local agency in-                             Individual instruction by   Competency
                                     services/training                            local agency trainer        Checklist OR
                                                                                                              Passing of LMS
                                                                                                              Pretest

                                                                                                              Local agency
                                                                                                              evaluation


  Anthropometric       CS/NES/       Anthropometric and    Week 2    Week 6       Anthropometric and          Anthropometric
  and Hematological    Supervisor/   Hematological Data                           Hematological Data          and
  Data Collection      RD            Collection LMS                               Collection LMS Course       Hematological
                                     Course (TBD by                               and Competency Checklist    Collection Final
                                     Dec 2009)                                                                Exam and
                                                                                  Scheduled with State        Competency
                                     Anthropometric and                           trainer and in-services     Checklist
                                     Lab Manual                                   and/or mentorship by Lead
                                                                                  Trainer                     Local agency
                                     State and/or Local                                                       and/or State
                                     Agency                                                                   evaluation
                                     Instructor-led
                                     Training
  Basic Nutrition      NES/          Basic Nutrition LMS   Month 3   Month 6      Basic Nutrition LMS         Basic Nutrition
                       Supervisor/   Course (TBD by                               Course and Competency       Final Exam and
                       RD            Dec 2009)                                    Checklist                   Competency
                                                                                                              Checklist OR
                                     CAC                                          Monthly in-services by      Passing of LMS
                                                                                  Lead Trainer                Pre-test
                                     RD in-services

ARIZONA WIC PROGRAM                                                                                                   ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                           REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education

     Core                Role            Possible            Start     Proposed    Methodology/Source             Evaluation            Hours
  Competencies                          Resources            Date     Completion                                                     Required to
                                                                         Date                                                       learn material
                                                                                   Nutrition 104 CAC course      Local agency
                                                                                                                 evaluation
                                                                                   WIC Works Learning
                                                                                   Online Modules

                                                                                   Online AZ WIC Training
                                                                                   Manual
  Nutrition During     NES/          Life Cycle Nutrition   Month 3     Month 6    Nutrition During Life Cycle   Life Cycle Final
  the Life Cycle       Supervisor/   LMS Course (TBD                               LMS Course and                Exam and
                       RD            by Dec 2009)                                  Competency Checklist          Competency
                                                                                                                 Checklist OR
                                     CAC                                           CAC                           Passing of LMS
                                                                                                                 Pre-test
                                     RD in-services                                Monthly in-services by
                                                                                   Lead Trainer                  Local agency
                                                                                                                 evaluation
                                                                                   WIC Works Learning
                                                                                   Online Modules

                                                                                   Online AZ WIC Training
                                                                                   Manual.
  Infant Nutrition     NES/          Infant Nutrition WIC   Month 3     Month 6    Infant Nutrition WIC Works    Infant Nutrition
  Series               Supervisor/   Works course in                               courses in LMS and            Final Exam and
                       RD            LMS – 3 courses                               Certificate of Completion     Competency
                                     (0-6 months, 6-12                                                           Checklist OR
                                     months, Formula                               CAC                           Passing of LMS
                                     Basics)                                                                     Pre-test
                                                                                   Monthly in-services by
                                     CAC                                           Lead Trainer                  Local agency
                                                                                                                 evaluation
                                     RD in-services                                WIC Works Learning
                                                                                   Online Modules

                                                                                   Online AZ WIC Training
                                                                                   Manual.
  Maternal Nutrition   NES/          Maternal Nutrition     Month 3     Month 6    Maternal Nutrition LMS        Maternal

ARIZONA WIC PROGRAM                                                                                                      ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                              REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education

     Core           Role           Possible          Start     Proposed    Methodology/Source          Evaluation           Hours
  Competencies                    Resources          Date     Completion                                                 Required to
                                                                 Date                                                   learn material
                  Supervisor/   LMS Course (TBD                            Course and Competency      Nutrition Final
                  RD            by Dec 2009)                               Checklist                  Exam and
                                                                                                      Competency
                                CAC                                        Monthly in-services by     Checklist OR
                                                                           Lead Trainer               Passing of LMS
                                WIC Works                                                             Pre-test
                                                                           WIC Works Learning
                                RD in-services                             Online Modules             Local agency
                                                                                                      evaluation
                                                                           Online AZ WIC Training
                                                                           Manual.
  Postpartum      NES/          Postpartum          Month 3     Month 6    Postpartum Nutrition LMS   Postpartum
  Nutrition       Supervisor/   Nutrition LMS                              Course and Competency      Nutrition Final
                  RD            Course (TBD by                             Checklist                  Exam and
                                Dec 2009)                                                             Competency
                                                                           CAC                        Checklist OR
                                CAC                                                                   Passing of LMS
                                                                           Monthly in-services by     Pre-test
                                RD in-services                             Lead Trainer
                                                                           WIC Works Learning         Local agency
                                                                           Online Modules             evaluation

                                                                           Online AZ WIC Training
                                                                           Manual

                                                                           CBC course
  Breastfeeding   NES/          Breastfeeding LMS   Month 3     Month 6    Breastfeeding LMS          Breastfeeding
                  Supervisor/   Course (TBD by                             Course and Competency      Final Exam and
                  RD            Dec 2009)                                  Checklist                  Competency
                                                                                                      Checklist OR
                                CBC                                        Monthly in-services by     Passing of LMS
                                                                           Lead Trainer               Pre-test
                                WIC Works
                                                                           CBC course                 Local agency
                                CAC                                                                   evaluation
                                                                           WIC Works Learning


ARIZONA WIC PROGRAM                                                                                          ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                  REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education

     Core              Role           Possible            Start     Proposed    Methodology/Source           Evaluation             Hours
  Competencies                       Resources            Date     Completion                                                    Required to
                                                                      Date                                                      learn material
                                                                                Online Modules

                                                                                CAC

                                                                                Online AZ WIC Training
                                                                                Manual
  Child Nutrition    NES/          Child Nutrition LMS   Month 3      Month 6   Child Nutrition LMS         Child Nutrition
                     Supervisor/   Course (TBD by                               Course and Competency       Final Exam and
                     RD            Dec 2009)                                    Checklist                   Competency
                                                                                                            Checklist OR
                                   Healthy Weight for                           CAC                         Passing of LMS
                                   Kids (CAC)                                                               Pre-test
                                                                                Monthly in-services by
                                   WIC Works                                    Lead Trainer                Local agency
                                                                                                            evaluation
                                                                                WIC Works Learning
                                                                                Online Modules

                                                                                Online AZ WIC Training
                                                                                Manual

                                                                                CBC course
  Customer Service   CS/NES/       WIC Works             Week 2    Week 6       Individual instruction by   WIC Works
                     Supervisor/   -OR-                                         Lead Trainer                completion of the
                     RD            ADHS DVD                                                                 final exam
                                                                                WIC Works Learning
                                                                                Online Modules –            Local agency
                                                                                Customer Service module     evaluation
                                                                                within ―Communicating
                                                                                with Participants‖
                                                                                -AND-
                                                                                Viewing of ADHS DVD
  Communication      NES/          WIC Works             Month 3   Month 6      Individual instruction by   WIC Works
  and Rapport        Supervisor/   -OR-                                         Lead Trainer                completion of the
  Building           RD/CS         ADHS-DVD                                                                 final exam
                                                                                WIC Works –

ARIZONA WIC PROGRAM                                                                                                 ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                         REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education

     Core                Role            Possible            Start     Proposed    Methodology/Source           Evaluation           Hours
  Competencies                          Resources            Date     Completion                                                  Required to
                                                                         Date                                                    learn material
                                                                                   ―Communicating with         Local agency
                                                                                   Participants‖               evaluation
                                                                                   -AND-
                                                                                   Viewing ADHS DVD
  Critical Thinking    NES/          WIC Works              Month 3   Month 6      Individual instruction by   Local agency
                       Supervisor/                                                 Lead Trainer                evaluation
                       RD
                                                                                   Monthly meeting lesson
                                                                                   and activities

                                                                                   WIC Works Learning
                                                                                   Online Modules

                                                                                   State VENA Classes
                                                                                   (DVD)
  Participant          NES/          PCE LMS Course         Month 3   Month 6      PCE LMS Course and          PCE Final Exam
  Centered Nutrition   Supervisor/   (TBD by Dec 2009)                             Competency Checklist        and Competency
  Education            RD            -OR-                                                                      Checklist
                                     Altarum DVD                                   Altarum DVD
                                                                                                               Viewing of DVD
  Multicultural        NES/          WIC Works              Month 3   Month 6      Individual instruction by   Local agency
  Awareness            Supervisor/                                                 Lead Trainer;               evaluation
                       RD/CS         Healthstream
                                     https://healthstream                          WIC Works                   Intro to CLAS
                                     .com/HLC/mphc;                                                            Final Exam and
                                                                                   Healthstream                Competency
                                     Intro to CLAS LMS                                                         Checklist OR
                                     Course                                        Monthly meeting lesson      Passing of Pre-
                                                                                   and activities              test

                                                                                   Intro to CLAS LMS Course
                                                                                   and Competency Checklist
  Facilitating Group   NES doing     ―Finding the           Month 3   Month 6      LMS Video & Practice        Local agency
  Discussion           group         Teacher Within‖                                                           observation
                       education/    ADHS – DVD
                       Supervisor/

ARIZONA WIC PROGRAM                                                                                                   ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                           REVISION: JANUARY 2011
Chapter Seven Participant and Staff Education

     Core              Role           Possible        Start     Proposed    Methodology/Source           Evaluation           Hours
  Competencies                       Resources        Date     Completion                                                  Required to
                                                                  Date                                                    learn material
                     RD            RD in-services
                     NES/          ADHS-DVD          Month 3   Month 6      3 ADHS DVDs                 Local agency
                     Supervisor/                                            (September 2008,            observation
                     RD                                                     January/February 2009,
                                                                            May/June 2009)
  Nutrition Care     NES/          Nutrition Care    Month 3   Month 6      Nutrition Care Standards    Nutrition Care
  Standards          Supervisor/   Standards LMS                            LMS Course and              Standards Final
                     RD            Course                                   Competency Checklist        Exam and
                                                                                                        Competency
                                   RD in-services                           Monthly meetings and        Checklist OR
                                                                            activities                  Passing of Pre-
                                                                                                        test

                                                                                                        Local Agency
                                                                                                        evaluation
  Missed Trainings   CS/NES/       Any ADHS- DVD’s   Month 6   Month 12     Scheduled with State
                     Supervisor/                                            trainer and in-services
                     RD                                                     and/or mentorship by Lead
                     depending                                              Trainer
                     on type of
                     training




ARIZONA WIC PROGRAM                                                                                            ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                    REVISION: JANUARY 2011
   Chapter Seven
   Participant and Staff Education

                                Counseling Observation Guide
   Staff name:                                         Date:

   Some Skills to Listen and                                 Observations:
         Watch for:                             Specific examples you heard or observed

 Opens the Appointment/
    Sets agenda

 Affirms participant

 Asks Some Open-Ended
    Questions

 Completes most of assessment
    before educating

 Allows time for participant to
    talk

 Summarizes what participant
    has said

 Provides nutrition education on
    appropriate, client-directed
    topics using PCE skills and
    emotion-based language

 Works with the participant for
    next steps/plan

 “Spirit” of PCE: shows genuine
    warmth; respectful; accepting
    and non-judgmental; avoids
    “should”, “need to”

Other?


   An approach to providing positive feedback:
     How do you feel the appointment/visit went?
     What do you think went well?
     If you could go back and do it over, what would you do differently?
     Here are some examples of things I heard you say…


   ARIZONA WIC PROGRAM                                               ORIGINAL: MARCH 1997
   POLICY AND PROCEDURE MANUAL                                       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education

         Appendix E: State Resource Catalog WIC order form

                              See Following Page




ARIZONA WIC PROGRAM                                ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL              7-90      REVISION: JANUARY 2011
     Chapter Seven
     Participant and Staff Education

                         Arizona Department of Health Services
                           Bureau of USDA Nutrition Services
            WIC Online Order form: http://warehouse.azbnp.gov/orderForm.aspx

                                    Nutrition Education Items




                                    Nutrition Education Items
                                                                           Out
    Product Name                     ID#                Unit of Issue      Of     # of Units
                                                                          Stock
A GUIDE TO ORAL HEALTH       WIC-0086-OHDPE              100 per pack
DURING PREGNANCY - ENG                                                                         Whole
                                                                                  Units of Issue Only




     ADHS/CFHS/ONS/WIC ORDER FORM    (REV. 05/05)                       Date Completed
        Chapter Seven
        Participant and Staff Education

  A GUIDE TO ORAL HEALTH         WIC-0087-OHDPS       100 per pack
  DURING PREGNANCY - SPN                                                                    Whole
                                                                               Units of Issue Only

A GUIDE TO ORAL HEALTH FOR      WIC-0090-OHCA1-3E     100 per pack
  CHILDREN AGES 1-3 - ENG                                                                   Whole
                                                                               Units of Issue Only

A GUIDE TO ORAL HEALTH FOR      WIC-0091-OHCA1-3S     100 per pack
  CHILDREN AGES 1-3 - SPN                                                                   Whole
                                                                               Units of Issue Only

A GUIDE TO ORAL HEALTH FOR      WIC-0088-OHYBFYE      100 per pack
  YOUR BABY'S FIRST YEAR -                                                                  Whole
            ENG                                                                Units of Issue Only

A GUIDE TO ORAL HEALTH FOR      WIC-0089-OHYBFYS      100 per pack
YOUR BABY'S FIRST YEAR - SPN                                                                Whole
                                                                               Units of Issue Only

 ARE YOU PASSING TOOTH         WIC-0094-PTDBWPLRG        Each
DECAY TO YOUR BABY? 22X28                                                                   Whole
  POSTER WITH PACIFIER -                                                       Units of Issue Only
        ENG/SPN

 ARE YOU PASSING TOOTH         WIC-0092-PTDBWSLRG        Each
DECAY TO YOUR BABY? 22X28                                                                   Whole
  POSTER WITH SPOON -                                                          Units of Issue Only
        ENG/SPN

         ARE YOU PASSING          WIC-0095-PTDBWPSM          Each
TOOTH DECAY TO YOUR BABY?                                                                   Whole
8.5X10 POSTER WITH PACIFIER                                                    Units of Issue Only
         - ENG/SPN

  ARE YOU PASSING TOOTH        WIC-0093-PTDBWSSM         Each
DECAY TO YOUR BABY? 8.5X10                                                                  Whole
   POSTER WITH SPOON -                                                         Units of Issue Only
         ENG/SPN

 HELPING YOUR BABY ADJUST      WIC-0109-HYBATNFE      100 per pack
   TO NEW FORMULA - ENG                                                                     Whole
                                                                               Units of Issue Only

 HELPING YOUR BABY ADJUST      WIC-0110-HYBATNFS      100 per pack
   TO NEW FORMULA - SPN                                                                     Whole
                                                                               Units of Issue Only

  IMPROVING WOMEN'S AND         WIC-0096-IWCOHF          Each
  CHILDREN'S ORAL HEALTH                                                                    Whole
    FLIPCHART - ENG/SPN                                                        Units of Issue Only

  THTM #1 NO CEREAL ZONE -     WIC-0031-NCZIFE0-6M    50 per pack
INFANT FEEDING 0-6 MONTHS -                                                                 Whole
            ENG                                                                Units of Issue Only

 THTM #11 VEGETABLE BABY         WIC-0047-VWICE       50 per pack
    FACE - INTRODUCING                                                                      Whole
     VEGETABLES - ENG                                                          Units of Issue Only

 THTM #11S VEGETABLE BABY        WIC-0048-VWICS       50 per pack
    FACE - INTRODUCING                                                                      Whole
     VEGETABLES - SPN                                                          Units of Issue Only




        ADHS/CFHS/ONS/WIC ORDER FORM   (REV. 05/05)                  Date Completed
        Chapter Seven
        Participant and Staff Education

 THTM #12 PREGNANT BELLY -       WIC-0049-PBE          50 per pack
PRENATAL WEIGHT GAIN - ENG                                                                   Whole
                                                                                Units of Issue Only

THTM #12S PREGNANT BELLY -       WIC-0050-PBS          50 per pack
PRENATAL WEIGHT GAIN - SPN                                                                   Whole
                                                                                Units of Issue Only

THTM #14 A NEW ME - TEENAGE    WIC-0051-ANMTPE         50 per pack
PREGNANCY/BREASTFEEDING -                                                                    Whole
            ENG                                                                 Units of Issue Only

   THTM #14S A NEW ME -        WIC-0052-ANMTPS         50 per pack
        TEENAGE                                                                              Whole
PREGNANCY/BREASTFEEDING -                                                       Units of Issue Only
           SPN

THTM #15 COLLEGE DIPLOMA -       WIC-0053-CDE          50 per pack
      SMOKING - ENG                                                                          Whole
                                                                                Units of Issue Only

THTM #15S COLLEGE DIPLOMA -      WIC-0054-CDS          50 per pack
       SMOKING - SPN                                                                         Whole
                                                                                Units of Issue Only

  THTM #16 SET THE TABLE -      WIC-0055-STTE          50 per pack
    FAMILY MEALS - ENG                                                                       Whole
                                                                                Units of Issue Only

 THTM #16S SET THE TABLE -      WIC-0056-STTS          50 per pack
    FAMILY MEALS - SPN                                                                       Whole
                                                                                Units of Issue Only

THTM #17 TEN TASTEFUL GIFTS     WIC-0057-TTGE          50 per pack
    - SUPERFOODS - ENG                                                                       Whole
                                                                                Units of Issue Only

 THTM #17S TEN TASTEFUL         WIC-0058-TTGS          50 per pack
 GIFTS - SUPERFOODS - SPN                                                                    Whole
                                                                                Units of Issue Only

THTM #18 GROW HAPPY KIDS -      WIC-0059-GHKE          50 per pack
   CHILD NUTRITION - ENG                                                                     Whole
                                                                                Units of Issue Only

THTM #18S GROW HAPPY KIDS -     WIC-0060-GHKS          50 per pack
   CHILD NUTRITION - SPN                                                                     Whole
                                                                                Units of Issue Only

THTM #19 FOLLOW THE LEADER       WIC-0061-FTLE         50 per pack
   - ROLE MODELING - ENG                                                                     Whole
                                                                                Units of Issue Only

  THTM #19S FOLLOW THE           WIC-0062-FTLS         50 per pack
 LEADER - ROLE MODELING -                                                                    Whole
           SPN                                                                  Units of Issue Only

 THTM #1S NO CEREAL ZONE -    WIC-0032-NCZIFS0-6M      50 per pack
INFANT FEEDING 0-6 MONTHS -                                                                  Whole
            SPN                                                                 Units of Issue Only

                    THTM #2                    WIC-                   50
                      THE                     0033-                   per                    Whole
                   AIRPLANE                  TAIFE6M                 pack       Units of Issue Only




        ADHS/CFHS/ONS/WIC ORDER FORM   (REV. 05/05)                   Date Completed
        Chapter Seven
        Participant and Staff Education

                   - INFANT
                   FEEDING
                       6
                   MONTHS -
                      ENG

    THTM #20 MAGIC CUP -         WIC-0063-MCE         50 per pack
       WEANING - ENG                                                                         Whole
                                                                                Units of Issue Only

   THTM #20S MAGIC CUP -         WIC-0064-MCS         50 per pack
      WEANING - SPN                                                                          Whole
                                                                                Units of Issue Only

THTM #21 FOOD FIGHTS - PICKY     WIC-0065-FFE         50 per pack
        EATING - ENG                                                                         Whole
                                                                                Units of Issue Only

    THTM #21S FOOD FIGHTS -        WIC-0066-FFS         50 per pack
      PICKY EATING - SPN                                                                     Whole
                                                                                Units of Issue Only

 THTM #22 BALANCE TAKES          WIC-0067-BTE         50 per pack
PRACTICE - FAST FOOD - ENG                                                                   Whole
                                                                                Units of Issue Only

  THTM #22S BALANCE TAKES        WIC-0068-BTS         50 per pack
 PRACTICE - FAST FOOD - SPN                                                                  Whole
                                                                                Units of Issue Only

  THTM #24 BABY DIAPER -         WIC-0069-BE          50 per pack
EDUCATING GRANDPARENTS -                                                                     Whole
           ENG                                                                  Units of Issue Only

  THTM #24S BABY DIAPER -        WIC-0070-BS          50 per pack
EDUCATING GRANDPARENTS -                                                                     Whole
           SPN                                                                  Units of Issue Only

THTM #26 GREATEST SHOW ON       WIC-0071-GSOEE        50 per pack
EARTH - ROLE MODELING - ENG                                                                  Whole
                                                                                Units of Issue Only

 THTM #26S GREATEST SHOW        WIC-0072-GSOES        50 per pack
         ON EARTH - ROLE                                                                     Whole
          MODELING - SPN                                                        Units of Issue Only

 THTM #27 SENSIBLE WEIGHT       WIC-0073-SWLE         50 per pack
LOSS - POSTPARTUM WEIGHT                                                                     Whole
    MANAGEMENT - ENG                                                            Units of Issue Only

THTM #27S SENSIBLE WEIGHT       WIC-0074-SWLS         50 per pack
LOSS - POSTPARTUM WEIGHT                                                                     Whole
    MANAGEMENT - SPN                                                            Units of Issue Only

   THTM #2S THE AIRPLANE -     WIC-0034-TAIFS6M       50 per pack
 INFANT FEEDING 6 MONTHS -                                                                   Whole
             SPN                                                                Units of Issue Only

THTM #4 SMILEY FACE - INFANT     WIC-0037-SFE         50 per pack
 FEEDING 8 - 12 MONTHS - ENG                                                                 Whole
                                                                                Units of Issue Only

   THTM #4S SMILEY FACE -        WIC-0038-SFS         50 per pack
INFANT FEEDING 8 - 12 MONTHS                                                                Whole




        ADHS/CFHS/ONS/WIC ORDER FORM   (REV. 05/05)                   Date Completed
        Chapter Seven
        Participant and Staff Education

           - SPN                                                               Units of Issue Only

 THTM #5 BABIES BLOSSOM -        WIC-0039-BBE         50 per pack
INFANT DEVELOPMENT - ENG                                                                    Whole
                                                                               Units of Issue Only

THTM #5S BABIES BLOSSOM -        WIC-0040-BBS         50 per pack
INFANT DEVELOPMENT - SPN                                                                    Whole
                                                                               Units of Issue Only

 THTM #7 OTHER USES FOR         WIC-0041-OUFBE        50 per pack
 BOTTLES - WEANING - ENG                                                                    Whole
                                                                               Units of Issue Only

 THTM #7S OTHER USES FOR        WIC-0042-OUFBS        50 per pack
  BOTTLES - WEANING - SPN                                                                   Whole
                                                                               Units of Issue Only

  THTM #9 BABY LEGS - ENG        WIC-0045-BLE         50 per pack
                                                                                            Whole
                                                                               Units of Issue Only

 THTM #9S BABY LEGS - SPN        WIC-0046-BLS         50 per pack
                                                                                            Whole
                                                                               Units of Issue Only

 THTM#3 TEACHING COLORS -     WIC-0035-TCIFE6-8M      50 per pack
INFANT FEEDING 6-8 MONTHS -                                                                 Whole
           ENG                                                                 Units of Issue Only

THTM#3S TEACHING COLORS -     WIC-0036-TCIFS6-8M      50 per pack
INFANT FEEDING 6-8 MONTHS -                                                                 Whole
           SPN                                                                 Units of Issue Only

  THTM#8 ULTRASOUND -            WIC-0043-USE         50 per pack
MOTHER'S AFFIRMATION - ENG                                                                  Whole
                                                                               Units of Issue Only

  THTM#8S ULTRASOUND -           WIC-0044-USS         50 per pack
MOTHER'S AFFIRMATION - SPN                                                                  Whole
                                                                               Units of Issue Only

  WHAT EVERYONE SHOULD        WIC-0106-WESKALPBE      100 per pack
KNOW ABOUT LEAD POISONING                                                                   Whole
    - BROCHURE - ENG                                                           Units of Issue Only

  WHAT EVERYONE SHOULD        WIC-0107-WESKALPBS      100 per pack
KNOW ABOUT LEAD POISONING                                                                   Whole
    - BROCHURE - SPN                                                           Units of Issue Only

 WIC CIRCLE CHART 11X17 -       WIC-0098-WCCC            Each
   CHILDREN - ENG/SPN                                                                       Whole
                                                                               Units of Issue Only

 WIC FOODS ARE CHANGING -         WIC-0077-TI         100 per pack
 TEASER INSERT - ENG/SPN -                                                                  Whole
   WILL BE DISCONTINUED                                                        Units of Issue Only
      OCTOBER 1, 2009




        ADHS/CFHS/ONS/WIC ORDER FORM   (REV. 05/05)                  Date Completed
        Chapter Seven
        Participant and Staff Education

WIC FOODS ARE CHANGING -        WIC-0080- WWICAGIF             100 per pack
WOMAN BREASTFEEDING AND                                                                                   Whole
  GIVING INFANT FORMULA -                                                                    Units of Issue Only
      ENG/SPN - WILL BE
 DISCONTINUED OCTOBER 1,
            2009

 WIC FOODS ARE CHANGING -        WIC-0079-WWICO                100 per pack
WOMAN BREASTFEEDING ONLY                                                                                  Whole
     - ENG/SPN - WILL BE                                                                     Units of Issue Only
 DISCONTINUED OCTOBER 1,
            2009

WIC FOODS ARE CHANGING -         WIC-0081-WPNWIC               100 per pack
 WOMAN POSTPARTUM NOT                                                                                     Whole
BREASTFEEDING - ENG/SPN -                                                                    Units of Issue Only
  WILL BE DISCONTINUED
     OCTOBER 31, 2009

 WIC FOODS ARE CHANGING:          WIC-0078-WICC                100 per pack
 WIC / CHILDREN - ENG/SPN -                                                                               Whole
   WILL BE DISCONTINUED                                                                      Units of Issue Only
       OCTOBER 1, 2009

 WIC FOODS ARE CHANGING:           WIC-0076-TT                       Each
TABLE TENTS - ENG/SPN - WILL                                                                              Whole
BE DISCONTINUED OCTOBER 1,                                                                   Units of Issue Only
           2009

 WIC TASTE POSTER - 26X18 -       WIC-0024-WTPE                      Each
         ENG ONLY                                                                                        Whole
                                                                                                  Units of Issue


                                         Breastfeeding Items
                                                                        Out Of
              Product Name                 ID#         Unit of Issue                 # of Units
                                                                        Stock
       BAG BREAST MILK STORAGE       BF-0004BBMS       12 per case
                                                                                           Whole Units
                                                                                          of Issue Only
          BAG COOLER BLACK             BF-0003-BCB     24 per case
        "BREASTMILK KEEPING A                                                              Whole Units
             GOOD THING"                                                                  of Issue Only

          BREAST SHIELD 30MM           BF-0007-BS       12 per bag
                                                                                           Whole Units
                                                                                          of Issue Only

       BREASTFEEDING FREEZER           BF-0026-PAK     36 per case
                PAK                                                                        Whole Units
                                                                                          of Issue Only

           BREASTFEEDING             BF-0008-BFMG      100 per pack
       MEDICATIONS GUIDELINES                                                              Whole Units
             BOOKMARK                                                                     of Issue Only




        ADHS/CFHS/ONS/WIC ORDER FORM    (REV. 05/05)                             Date Completed
 Chapter Seven
 Participant and Staff Education

  BREASTPUMP HOSPITAL          BF-0015-BPHG        Each
     GRADE - LACTINA                                                             Whole Units
                                                                                of Issue Only

 BREASTPUMP PERSONAL           BF-0016-BPPU      3 per case
         USE                                                                     Whole Units
                                                                                of Issue Only

 CLIPS FOR REPLACEMENT         BF-0011-CFRC        Each
          CASE                                                                   Whole Units
                                                                                of Issue Only

  GAUGE BREAST PUMPS            BF-0005-GBP        Each
                                                                                 Whole Units
                                                                                of Issue Only

     HERE IS YOUR                BF-0014-       100 per pack
 BREASTFEEDING BACK TO          HYBFBTWK                                         Whole Units
       WORK KIT                                                                 of Issue Only

KEEP IT SIMPLE - BOOK - ENG    BF-0018-KISE      90 per box
                                                                                 Whole Units
                                                                                of Issue Only

KEEP IT SIMPLE - BOOK - SPN    BF-0019-KISS      90 per box
                                                                                 Whole Units
                                                                                of Issue Only

     LACTINA DOUBLE           BF-0017-LDBPK     20 per case
     BREASTPUMP KIT                                                              Whole Units
                                                                                of Issue Only

      LUGGAGE TAG               BF-0022-LT         Each
                                                                                 Whole Units
                                                                                of Issue Only

     MAGNET HOTLINE             BF-0023-MHL        Each
                                                                                 Whole Units
                                                                                of Issue Only

  MEDELA LACTINA PLUS         BF-0028-MLPRC        Each
   REPLACEMENT CASE                                                              Whole Units
                                                                                of Issue Only

        NURSE PAD               BF-0025-NP      100 per pack
                                                                                 Whole Units
                                                                                of Issue Only

 POSTER - BREASTFEEDING       BF-0029-BFMGMP       Each
  MOMS GET MORE 2009 -                                                           Whole Units
        ENG/SPN                                                                 of Issue Only

 SCARF - BREASTFEEDING         BF-0006-SBFP       10 per
         PRIVACY                                  bundle




                                Client Participation Items
          Product Name                  ID#         Unit of Issue   Out Of   # of Units



 ADHS/CFHS/ONS/WIC ORDER FORM    (REV. 05/05)                          Date Completed
Chapter Seven
Participant and Staff Education

                                                                  Stock
 ARIZONA COMPLAINT HOTLINE         WIC-0084-ACHF   100 per pack
           FLYER                                                                       Whole
                                                                          Units of Issue Only

   FOOD LIST - ENG - WILL BE        WIC-0005-FLE   50 per pack
DISCONTINUED OCTOBER 31, 2009                                                          Whole
                                                                          Units of Issue Only

  FOOD LIST LAMINATED - SPN -      WIC-0008-FLLS   100 per pack
WILL BE DISCONTINUED OCTOBER                                                           Whole
            31, 2009                                                      Units of Issue Only

   NEW FOOD LIST BOOKLET -           WIC-0010-     360 per pack
          ENG/SPN                    NFLBES                                            Whole
                                                                          Units of Issue Only
 PHYSICIANS' TEAR PAD - AZ WIC       WIC-0105-     100 per pad
  MILK ALTERNATIVE REQUEST           PTPMARF                                           Whole
       FORM - ENG ONLY                                                    Units of Issue Only

 PHYSICIANS' TEAR PAD - AZ WIC       WIC-0103-     100 per pad
      SPECIAL FORMULA              PTPSFAFCWHI                                         Whole
   AUTHORIZATION FORM FOR                                                 Units of Issue Only
    CHILDREN, WOMEN, AND
  HEALTHY INFANTS - ENG ONLY
 PHYSICIANS' TEAR PAD - AZ WIC        WIC-0104-    100 per pad
      SPECIAL FORMULA               PTPSFAFPMFI                                        Whole
   AUTHORIZATION FORM FOR                                                 Units of Issue Only
  PREMATURE AND MEDICALLY
  FRAGILE INFANTS - ENG ONLY
  PHYSICIANS' TOOL KIT - ENG       WIC-0108-PTKE      Each
           ONLY                                                                        Whole
                                                                          Units of Issue Only
WHAT IS WIC - BROCHURE - ENG         WIC-0017-     100 per pack
                                      WIWBE                                            Whole
                                                                          Units of Issue Only
 WHAT IS WIC - BROCHURE - SPN        WIC-0018-     100 per pack
                                      WIWBS                                            Whole
                                                                          Units of Issue Only
WHAT TO BRING/TYPE APP. - SPN -      WIC-0020-     100 Per pack
WILL BE DISCONTINUED OCTOBER         WTBTAS                                            Whole
            1, 2009                                                       Units of Issue Only

WIC NEW FOODS POSTER - 24X18         WIC-0023-        Each
      - ENG/SPN - WILL BE            WNFPES                                            Whole
DISCONTINUED OCTOBER 1, 2009                                              Units of Issue Only

 WIC CUSTOMER SAVINGS - ENG        WIC-0025-WCSE   100 per pack
                                                                                       Whole
                                                                          Units of Issue Only




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Chapter Seven
Participant and Staff Education

               Appendix F: Hemoglobin Cut-Off Values

                              See following pages




ARIZONA WIC PROGRAM                                 ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL         7-101           REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education

     Cut-off values for Hemoglobin Levels at 0-2,999 feet

                                                               Pregnant                    Breastfeeding/Post-Partum          Infant and Child

                                                   1st            2nd            3rd
                                                Trimester      Trimester      Trimester    12 years to                  Infant             Child
                                                 0 – 13         14 – 26                    14 years 11                  6 to 23
                                 action
     Smoking Status                              weeks          weeks        27 + weeks      months      15 years +     months         2 to 5 years


                                Anemia         10.9           10.4           10.9          11.7          11.9          10.9            11.0
  Non-Smoker
                              Nutritionist      8.5   16.3     8.1   15.9     8.5   16.3    9.2   17.0    8.8   16.6    7.9    15.7      8.2     16.0

                                Anemia         11.2           10.7           11.2          12.0          12.2
  up to 1 pack
  (1-19 cigarettes)
                              Nutritionist      8.8   16.6     8.3   16.1     8.8   16.6    9.5   17.3    9.4   17.2

                                Anemia         11.4           10.9           11.4          12.2          12.4
  1-2 packs
  (20-39 cigarettes)
                              Nutritionist      9.5   17.3     7.9   15.7     9.5   17.3    9.7   17.5    9.9   17.7

                                Anemia         11.6           11.1           11.6          12.4          12.6
  2+ packs
  (40+ cigarettes)
                              Nutritionist     10.2   18.0     7.5   15.3    10.2   18.0    9.9   17.7   10.4   18.2


    Hemoglobin values at or below the "Anemia" cutoff are reported as anemic in WIC
    Hemoglobin values outside the "Nutritionist" range are referred to a Nutritionist




ARIZONA WIC PROGRAM                                                                                          ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                  REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education

      Cut-off values for Hemoglobin Levels at 3,000-3,999 feet

                                                               Pregnant                    Breastfeeding/Post-Partum          Infant and Child

                                                   1st            2nd            3rd
                                                Trimester      Trimester      Trimester    12 years to                  Infant             Child
                                                 0 – 13         14 – 26                    14 years 11                  6 to 23
                                 action
     Smoking Status                              weeks          weeks        27 + weeks      months      15 years +     months         2 to 5 years


                                Anemia         11.1           10.6           11.1          11.9          12.1          11.1            11.2
  Non-Smoker
                              Nutritionist      9.0   16.8     8.6   16.4     9.0   16.8    9.4   17.2    9.3   17.1    8.3    16.1      8.7     16.5

                                Anemia         11.4           10.9           11.4          12.2          12.4
  up to 1 pack
  (1-19 cigarettes)
                              Nutritionist      9.3   17.1     8.8   16.6     9.3   17.1    9.7   17.5    9.8   17.6

                                Anemia         11.6           11.1           11.6          12.4          12.6
  1-2 packs
  (20-39 cigarettes)
                              Nutritionist     10.0   17.8     8.4   16.2    10.0   17.8    9.9   17.7   10.3   18.1

                                Anemia         11.8           11.3           11.8          12.6          12.8
  2+ packs
  (40+ cigarettes)
                              Nutritionist     10.7   18.5     8.0   15.8    10.7   18.5   10.1   17.9   10.8   18.6


    Hemoglobin values at or below the "Anemia" cutoff are reported as anemic in WIC
    Hemoglobin values outside the "Nutritionist" range are referred to a Nutritionist




ARIZONA WIC PROGRAM                                                                                          ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                  REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education

      Cut-off values for Hemoglobin Levels at 4,000-4,999 feet

                                                               Pregnant                    Breastfeeding/Post-Partum          Infant and Child

                                                   1st            2nd            3rd
                                                Trimester      Trimester      Trimester    12 years to                  Infant             Child
                                                 0 – 13         14 – 26                    14 years 11                  6 to 23
                                 action
     Smoking Status                              weeks          weeks        27 + weeks      months      15 years +     months         2 to 5 years


                                Anemia         11.2           10.7           11.2          12.0          12.2          11.2            11.3
  Non-Smoker
                              Nutritionist      9.1   16.9     8.8   16.6     9.1   16.9    9.5   17.3    9.4   17.2    8.4    16.2      8.8     16.6

                                Anemia         11.5           11.0           11.5          12.3          12.5
  up to 1 pack
  (1-19 cigarettes)
                              Nutritionist      9.4   17.2     9.0   16.8     9.4   17.2    9.8   17.6    9.9   17.7

                                Anemia         11.7           11.2           11.7          12.5          12.7
  1-2 packs
  (20-39 cigarettes)
                              Nutritionist     10.2   18.0     8.6   16.4    10.2   18.0   10.0   17.8   10.4   18.2

                                Anemia         11.9           11.4           11.9          12.7          12.9
  2+ packs
  (40+ cigarettes)
                              Nutritionist     10.9   18.7     8.2   16.0    10.9   18.7   10.2   18.0   10.9   18.7


    Hemoglobin values at or below the "Anemia" cutoff are reported as anemic in WIC
    Hemoglobin values outside the "Nutritionist" range are referred to a Nutritionist




ARIZONA WIC PROGRAM                                                                                          ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                  REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education

      Cut-off values for Hemoglobin Levels at 5,000-5,999 feet

                                                               Pregnant                    Breastfeeding/Post-Partum          Infant and Child

                                                   1st            2nd            3rd
                                                Trimester      Trimester      Trimester    12 years to                  Infant             Child
                                                 0 – 13         14 – 26                    14 years 11                  6 to 23
                                 action
     Smoking Status                              weeks          weeks        27 + weeks      months      15 years +     months         2 to 5 years


                                Anemia         11.4           10.9           11.4          12.2          12.4          11.4            11.5
  Non-Smoker
                              Nutritionist      9.3   17.1     8.9   16.7     9.3   17.1    9.7   17.5    9.5   17.3    8.5    16.3      8.9     16.7

                                Anemia         11.7           11.2           11.7          12.5          12.7
  up to 1 pack
  (1-19 cigarettes)
                              Nutritionist      9.6   17.4     9.2   17.0     9.6   17.4   10.0   17.8   10.1   17.9

                                Anemia         11.9           11.4           11.9          12.7          12.9
  1-2 packs
  (20-39 cigarettes)
                              Nutritionist     10.3   18.1     8.8   16.6    10.3   18.1   10.2   18.0   10.6   18.4

                                Anemia         12.1           11.6           12.1          12.9          13.1
  2+ packs
  (40+ cigarettes)
                              Nutritionist     11.0    0.0     8.4   16.2    11.0   18.8   10.4   18.2   11.1   18.9


    Hemoglobin values at or below the "Anemia" cutoff are reported as anemic in WIC
    Hemoglobin values outside the "Nutritionist" range are referred to a Nutritionist




ARIZONA WIC PROGRAM                                                                                          ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                  REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education

      Cut-off values for Hemoglobin Levels at 6,000-6,999 feet

                                                               Pregnant                    Breastfeeding/Post-Partum          Infant and Child

                                                   1st            2nd            3rd
                                                Trimester      Trimester      Trimester    12 years to                  Infant             Child
                                                 0 – 13         14 – 26                    14 years 11                  6 to 23
                                 action
     Smoking Status                              weeks          weeks        27 + weeks      months      15 years +     months         2 to 5 years


                                Anemia         11.6           11.1           11.6          12.4          12.6          11.6            11.7
  Non-Smoker
                              Nutritionist      9.4   17.2     9.1   16.9     9.4   17.2    9.9   17.7    9.7   17.5    8.7    16.5      9.1     16.9

                                Anemia         11.9           11.4           11.9          12.7          12.9
  up to 1 pack
  (1-19 cigarettes)
                              Nutritionist      9.7   17.5     9.3   17.1     9.7   17.5   10.2   18.0   10.2   18.0

                                Anemia         12.1           11.6           12.1          12.9          13.1
  1-2 packs
  (20-39 cigarettes)
                              Nutritionist     10.5   18.3     8.9   16.7    10.5   18.3   10.4   18.2   10.7   18.5

                                Anemia         12.3           11.8           12.3          13.1          13.3
  2+ packs
  (40+ cigarettes)
                              Nutritionist     11.2   19.0     8.5   16.3    11.2   19.0   10.6   18.4   11.2   19.0


    Hemoglobin values at or below the "Anemia" cutoff are reported as anemic in WIC
    Hemoglobin values outside the "Nutritionist" range are referred to a Nutritionist




ARIZONA WIC PROGRAM                                                                                          ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                  REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education

      Cut-off values for Hemoglobin Levels at 7,000-7,999 feet

                                                               Pregnant                    Breastfeeding/Post-Partum          Infant and Child

                                                   1st            2nd            3rd
                                                Trimester      Trimester      Trimester    12 years to                  Infant             Child
                                                 0 – 13         14 – 26                    14 years 11                  6 to 23
                                 action
     Smoking Status                              weeks          weeks        27 + weeks      months      15 years +     months         2 to 5 years


                                Anemia         11.9           11.4           11.9          12.7          12.9          11.9            12.0
  Non-Smoker
                              Nutritionist      9.6   17.4     9.3   17.1     9.6   17.4   10.2   18.0    9.8   17.6    8.8    16.6      9.2     17.0

                                Anemia         12.2           11.7           12.2          13.0          13.2
  up to 1 pack
  (1-19 cigarettes)
                              Nutritionist      9.9   17.7     9.5   17.3     9.9   17.7   10.5   18.3   10.4   18.2

                                Anemia         12.4           11.9           12.4          13.2          13.4
  1-2 packs
  (20-39 cigarettes)
                              Nutritionist     10.6   18.4     9.1   16.9    10.6   18.4   10.7   18.5   10.8   18.6

                                Anemia         12.6           12.1           12.6          13.4          13.6
  2+ packs
  (40+ cigarettes)
                              Nutritionist     11.3   19.1     8.7   16.5    11.3   19.1   10.9   18.7   11.3   19.1


    Hemoglobin values at or below the "Anemia" cutoff are reported as anemic in WIC
    Hemoglobin values outside the "Nutritionist" range are referred to a Nutritionist




ARIZONA WIC PROGRAM                                                                                          ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL                                                                                  REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education

   Appendix G: Arizona State Nutrition Education Care Standards

                              See following pages




ARIZONA WIC PROGRAM                                 ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL         7-108           REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM               ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education

        Appendix H : WIC Workforce Position Definitions
                        See following pages




ARIZONA WIC PROGRAM                           ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL      7-186        REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education

                 WIC Workforce Position Definitions
               Position                             Definition
RD                                 A Registered Dietitian is a degreed
                                   professional staff with a minimum of a
                                   bachelor’s degree with RD credentials
                                   and performs the following: high risk
                                   counseling, formula authorization, and
                                   certification of clients. RD’s may have
                                   multiple roles such Clinic Supervisor,
                                   WIC Director and/or High Risk
                                   Nutritionist. They are expected to be
                                   able to perform all duties associated
                                   with paraprofessional staff including
                                   breast feeding counseling.

Degreed Nutritionist               A WIC Nutritionist is a degreed
                                   professional staff with a minimum of a
                                   bachelor’s degree who has not
                                   acquired their RD credentials. They are
                                   able to perform medium risk counseling
                                   as well as perform all duties associated
                                   with the Nutrition Education Specialist.

DTR                                A Registered Dietetic Technician that is
                                   a degreed professional staff with a
                                   minimum of an associate’s degree with
                                   DTR credentials. A DTR is able to
                                   perform the same duties as a degreed
                                   nutritionist.

Nutritionist                       A general term used to describe a
                                   degreed WIC professional staff
                                   member who can complete WIC
                                   certifications and provide nutrition
                                   education. Most common positions
                                   referenced as nutritionist in WIC are
                                   the RD, Degreed Nutritionist, and DTR.

                                                      Continued on Next Page




ARIZONA WIC PROGRAM                             ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL       7-187         REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education

         WIC Workforce Position Definitions (Continued)
             Position                           Definition
Paraprofessional                 A general term used to describe a WIC
                                 staff member who is trained to assist
                                 professional staff (ie: RD, Nutritionist,
                                 Supervisors) but are not themselves
                                 degreed or certified at a professional
                                 level. Most common positions
                                 referenced as paraprofessionals in
                                 WIC are the Clerk, Receptionist,
                                 CNW/CPA, Certification Specialist, or a
                                 non-degreed Nutrition Education
                                 Specialist.

CS                               A Certification Specialist describes a
                                 paraprofessional WIC staff member
                                 whose primary job responsibility is to
                                 complete the WIC certification process
                                 on categorically eligible participants up
                                 through the medical and
                                 anthropometric collection. Other duties
                                 may include clerk responsibilities such
                                 as managing phones and appointment
                                 scheduling. This term replaces the
                                 Community Nutrition Worker and
                                 Competent Professional Authority
                                 designations.

NES                              A Nutrition Education Specialist
                                 describes a paraprofessional or
                                 degreed professional WIC staff
                                 member whose primary job resp. is to
                                 complete health history and nutrition
                                 assessment, review of client risks,
                                 provide nutrition education, develop
                                 participant centered care plan and
                                 behavioral goal setting, provide
                                 referrals, tailor food package and issue
                                 food instruments. In addition, they are
                                 expected to be able to perform all
                                 duties of the CS. This term replaces
                                 the Community Nutrition Worker and
                                 Competent Professional Authority
                                 designations.
ARIZONA WIC PROGRAM                           ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL     7-188         REVISION: JANUARY 2011
Chapter Seven
Participant and Staff Education




ARIZONA WIC PROGRAM                   ORIGINAL: MARCH 1997
POLICY AND PROCEDURE MANUAL   7-189   REVISION: JANUARY 2011

				
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