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DHH Outlines Major Changes to Improve Monitoring of Vendors in Louisiana's WIC Program

Department-requested audit helps guide improvements that will ensure quality for participants, protect taxpayer dollars.
BATON ROUGE, La. (DHH) -- The Department of Health and Hospitals announced Monday that it is enacting major changes in its administration of the State's Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), following a DHH-requested audit of its operations, including enhanced procedures for monitoring vendors, their prices and their performance.

In addition, DHH will improve its communication with the Supplemental Nutrition Assistance Program (SNAP), which is run by the Department of Children and Family Services, to ensure that DCFS is informed when vendors are disqualified by WIC, so that it can determine if the vendor should remain inthe SNAP program. DHH also will hire a nutritionist to serve as the Continuing Quality Improvement Coordinator and ensure that the program's goals are being met and begin to use its trained sanitarians to inspect vendor facilities when complaints of unsanitary conditions exist.

In an effort to improve operations and performance of Louisiana's WIC program, in the Fall of 2012 DHH leadership requested that the Louisiana Legislative Auditors (LLA) conduct a comprehensive performance evaluation of the program.

DHH Secretary Kathy Kliebert said, "We requested this audit to guide us in improving the WIC program for those who rely on its critical services, while also protecting taxpayer dollars and ensuring that any bad vendors are no longer allowed to participate in the program. WIC serves an average of 140,000 participants each month and accounts for one-third of the Office of Public Health's budget, which underscores why it is important to us that the program runs efficiently."

Assistant Secretary for Public Health JT Lane said, "Significant improvement is not an option - it is a necessity. We recently announced major successes in improving our restaurant inspections process, and we will focus that same energy on improving the WIC's operations. We have started down the path towards better monitoring of vendors and enforcement of program rules and regulations. Over the next year, we expect to see a transformation that drastically improves the state of WIC in Louisiana."

PROCESS IMPROVEMENTS

The two most substantial changes are the creation of a WIC Vendor Operations Manual that providesclear and consistent guidance, information, protocols and procedures for WIC employees in working with vendors, and the creation of a WIC Vendor Monitoring Database to track the status and vital information on all WIC-approved vendors. Both the Vendor Operations Manual and the Vendor Monitoring Database must be approved by the USDA before the program may begin using them.

The enhanced WIC Vendor Operations Manual will include:

  • Clear procedural guidelines for oversight of the vendor application process, tier assignments, competitive pricing and vendor monitoring.
  • A new monitoring tool designed to more comprehensively monitor visits, including stock checks with verification of store prices based on what the vendor submits to DHH, an overall assessmentof the store's WIC program and sanitary conditions of the store from the Retail Food Inspection Program
  • Protocols for proper notification of the USDA of all WIC vendor disqualifications using the new Vendor Monitoring Database.
  • Procedures for monitoring and investigating high-risk vendors; and
  • An enhanced vendor sanction schedule and a corrective action plan template for vendors.

The new Vendor Monitoring Database will track:

  • The qualification or disqualification of all WIC vendors, including a notification to the SNAP program when a vendor is disqualified from WIC;
  • Stock checks and submitted prices at each WIC vendor;
  • All activities of high-risk vendors, including reminders to ensure follow-up actions are taken on pending investigations in coordination with the fraud prevention team; and
  • A vendor tracking spreadsheet to monitor reports and activities related to a vendor's monitoring schedule.

In addition, OPH will begin using new auditing software recommended by the Louisiana Legislative Auditor and the USDA Southwest Regional Office, which will help WIC staff members analyze vendor data, monitor needs and apply data to improve vendor management overall.

Beginning early in 2014, vendor inspections will be done by the health inspectors who currently conduct retail food inspections throughout the state. This joint effort will allow for rapid sharing of information between the sanitarians and the WIC program staff. Already, WIC vendor unit employees are making referrals to health inspectors when they notice unsanitary conditions at WIC-approved vendors.

In order to ensure that WIC clinics are providing all services to recipients within program requirements, the Assistant Director of Nutrition Services drafted a new management evaluation schedule. The WIC program is also hiring an additional nutritionist to serve as the Continuing Quality Improvement Coordinator, implementing training and technical assistance to ensure quality improvements.
Beginning in January 2014, Regional nutritionists for the WIC program will be actively involved in monitoring WIC clinics and utilizing data within their regions to enhance clinic operations and efficiencies. Their current administrative responsibilities will be shifted to the State agency staff so that they can focus their attention to the vendors in their regions.

The WIC program is also continuing to pursue the implementation of an EBT program. A revised plan for implementation drafted in coordination with the USDA regional EBT consultant and DHH's IT department set the implementation goal for February 2018. DHH's IT division has prioritized this project and assigned a project manager to work with the WIC EBT coordinator to track and guide the project through implementation.

For more information about WIC, visit dhh.louisiana.gov/WIC.
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