Action During WIC Shutdown

10 years 5 months ago

October 11, 2013

Update: Funds are available through the end of October and further contingencies will have to be developed if the Fed shutdown continues beyond that point.  More here.

October 9, 2013

In the face of the Fed shutdown, North Carolina WIC finds itself in an unusual spot. I became aware of this situation today as a result of conversation with our NICU discharge planner.  WIC will not have funds to support dispensing of new product (read specialty formulas) until the shutdown is over. WIC vouchers already distributed will be honored. This will impact many newborn care areas but in particular will affect NICUs discharging premature infants (post necrotizing enterocolitis, at risk for growth delay, anemia, and cerebral palsy), infants with metabolic disorders and some genetic conditions, and babies suffering from chronic medical conditions such as congenital cardiac disease, renal disease, malabsorption syndromes, significant allergies and a number of other disorders.

During the period of curtailed WIC services, WIC will be taking names for new patients and will be ready to enroll these patients when the shutdown ends. Remember providers as well as families need to be brought up to speed on what this is all about. This is an unfortunate but great family centered care opportunity. No matter what, make sure that all of your eligible patients get registered at the WIC office despite the fact that WIC will not be able to immediately support their infant’s nutritional needs. This is critical! WIC will start processing those applications when the shutdown ends.

As to how to support infants with special dietary needs during this period there are at least two alternative methods to consider:

  1. The NC Division of Medical Assistance (DMA…NC Medicaid) will support the screening, diagnosis and treatment of infants with medical nutrition needs. This program is called EPSDT. It includes coverage of specialty formula as a durable medical good (DME). Some facilities caring for older children with such needs are familiar with this process. Older children with such needs likely are cared for in pediatric cardiology, pulmonology and GI clinics. Use staff in these clinics as your local resource for dealing with this issue. Per the EPSDT policy pre-approval is not required. Infants do not require pre-approval. A prescription will be required and a supplier for this will need to be identified. Justification of the nutritional need will need to be documented in the chart. This is the link to the DMA EPSDT Policy and the standard nutrition request form:

 http://www.ncdhhs.gov/dma/mp/1-I.pdf http://www.ncdhhs.gov/dma/forms/OralNutritionProdReq.pdf

 

  1. Another option is considering asking formula companies to support the need. I understand this fully flies in the face of Baby Friendly efforts ongoing across the state but it may be an avenue we need to consider especially if it becomes challenging to find home health providers willing to take on the formula burden.     

Here is an example of how this process works thanks to our most excellent Discharge Planner Christine! “I just spoke with Autumn Home Nutrition and was told that they would provide formula as long as it’s medically indicated (dx of failure to thrive, acid reflux, NEC, low birth weight, etc.). They are sending me the oral nutrition form that the MD has to complete as part of the referral process. As long as the pt is Medicaid (not “Medicaid pending status”) they would verify insurance and coverage of the formula requested. If Medicaid denies the formula prescribed Autumn would contact us to discuss other formula alternatives that Medicaid would authorize. Autumn will subsequently contact the families to verify address, etc. The formula is then shipped to the family monthly. This sounds way too easy. She did state that they have been receiving a lot of calls/inquiries since WIC is shut down.”

 

You all may develop more insight or up to data information on this than I have but I thought it was important to start spreading the word. Please forward any comments or updates you have to me at [email protected]. We can use the PQCNC email list as one method to get information out to folks regarding this issue. Share this message widely and if folks want to get on the PQCNC mailing list please have them subscribe at www.pqcnc.org. We will report on updates as meaningful information becomes available. 

Godspeed all!!!

Marty McCaffrey

PQCNC Director