Immunizations and Georgia WIC Presentation to Nutrition Services

Immunizations and Georgia WIC Presentation to: Nutrition Services Directors Presented by: Barbara Stahnke & Angela Bradford Date: March 28 -29, 2017

Objectives: • Identify state WIC policies and federal guidance for immunization referrals • Discuss current procedures used by local agencies to screen and refer participants for immunizations to assist in establishing a uniform process

Immunizations & Georgia WIC Procedures • Participant Referral to other Agencies (NS 200. 06) – Staff should refer participants to other health services offered within the health department system and other agencies and services • Immunization Coverage Assessment (CT- 820. 03) – Local agencies (LA) shall ensure WIC infants and children are screened and referred for immunizations at certification and midyear assessments using Georgia Registry Immunization Tracking System (GRITS) or the participant’s immunization record

Immunizations & USDA WIC Regulations • § 246. 7(b) Program referral and access. – State and local agencies shall provide WIC Program applicants and participants or their designated proxies with information on other health-related and public assistance programs, and when appropriate, shall refer applicants and participants to such programs.

Immunizations & USDA –FNS WIC Guidance • Nutrition Services Standards: Collaboration with immunization programs to ensure all WIC participants receive information and referrals for necessary vaccines • VENA Guidance: No specific guidance

Immunizations & USDA –FNS WIC Guidance (cont. ) • As an adjunct to services that provide immunizations, the WIC Program’s role is to find out about a child’s need for immunizations and share that information with parents, including where to get a child immunized https: //www. fns. usda. gov/wic/immunization-screening-and-referral-wic

Immunizations & USDA –FNS WIC Guidance (cont. )

Sample Screening and Referral Process Rickert DL, et al. Counting the shots: a model for immunization screening and referral in nonmedical settings. Pediatrics. 2003 Jun; 111(6 Pt 1): 1297 -302.

Caveat – USDA – WIC “Where resources allow, WIC may implement other measures to increase immunization rates of WIC children in conjunction with the State Immunization program. “ • For example – having a Georgia DPH Nurse in a WIC clinic providing immunizations.

Analysis of Federal Regulations and Guidance • Required to make health care referrals – Regulation • Required to Screen and Refer – USDA Policy & Guidance • Required to request immunization records, Screen and Refer – Georgia WIC Policy • Immunization screening and referral must not impact WIC benefits – USDA Policy & Guidance and Georgia WIC Policy

Georgia Immunization Study 2015 • Methods: January 2013 Birthdate; 2, 225 children in Georgia • WIC enrollment defined if enrolled in WIC for any amount of time in the first 24 months of life Designated as “enrolled in WIC” • Up-to-date (UTD) defined as all doses given within 24 months of child’s birthdate or meet Advisory Committee on Immunization Practices (ACIP) catch up conditions • Limitations did not describe the limitations with the definition for “enrolled in WIC”

Georgia Immunization Study 2015 (cont. )

Questions from DPH Immunization Program How does your staff assess immunizations data? Do they regularly assess and refer? How do they refer? What immunizations training does WIC Staff receive? • What are the barriers to immunizations and WIC collaborations? • •

Summary/Next Steps • Work with Georgia DPH Immunizations to develop materials for WIC clinic use • Other – Based on conversation

What questions do you have?

Thank you! For additional questions or concerns, contact: Angela Bradford angela. bradford@dph. ga. gov