September 17, 2007 WIC Update

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SUBJECT 1: Missouri Approved for a New Data System
SUBJECT 2: New Name for Division of Medical Services
SUBJECT 3: 2 to 5 Year Growth Chart Clarification
SUBJECT 4: Fit WIC MO FFY 2007 Evaluation
SUBJECT 5: Updated WIC Reference Sheets for the WIC Formulas, Foods, and Food Packages
SUBJECT 6: Microcuvette Delivery

  1. Missouri Approved for a New Data System:  We were notified on September 13 by Jean Liekhus, USDA Regional WIC Program Director, that Missouri has been approved for a new WIC data system.  We have been waiting and waiting for this good news.  In talking with Jean, the reason decisions were delayed was due to USDA needing to ensure that there were adequate funds available for food expenses.  With increasing caseloads in most states, increasing food costs and reduced funds coming back in rebates, money was very, very tight.  USDA has been using contingency funds to help states meet food expenses, so until USDA was confident states had enough funds to provide needed WIC services they were reluctant to commit for new IT projects.

    Nevertheless, USDA was able to find enough money to fund our project.  Mark Davis and Larry Rutledge will be meeting with agencies in October to share this good news and discuss what it will mean and the time line.  If you have not made plans to attend the October program updates meeting in your area, we encourage you to reconsider.  A reminder about these meetings went out in the September 4 weekly update.  A team of state and local staff will be going to Oklahoma in mid October to thoroughly look at the model system we will be transferring.  When they get back, the real planning and work will begin.  Our time line has us implementing a pilot by late 2008.  We thank all local agencies for providing information on printer needs and site locations.  This was an important piece of our application for funding.  If you have questions or want more information, please contact Mark Davis at or Larry Rutledge at  It is going to be an exciting year in WIC!

  2. New Name for Division of Medical Services:  The 2007 legislative session ended with the passage of Senate Bill 577, the Missouri Health Improvement Act of 2007.  Among its many provisions, Senate Bill 577 renames Missouri Medicaid to MO HealthNet.  Effective September 1, the Department of Social Services, Division of Medical Services, changed its name to the MO HealthNet Division.  To assist in their transition effort, please change any references to the Division of Medical Services in any materials, such as references on websites, in new grant applications, correspondence, or brochures, to the MO HealthNet Division (formerly known as the Division of Medical Services).  Also, effective September 1, the Division of Medical Services website address changed to  All other contact information, such as address, telephone numbers, and e-mail addresses, remain the same.  If you have questions, please call the MO HealthNet Division at 573-751-3425.
  3. 2 to 5 Year Growth Chart Clarification:  The state office has received questions from local WIC providers regarding plotting procedures for children 2 years and older.  Children two years of age and older, and a minimum 29 ½ inches standing height (stature), must be measured using the adult equipment and then plotted on the 2 to 20 year growth charts.

    The front-side was modified with the following characteristics in 2004: only the 2-5 year age range is represented.  This modification allows for more space between age indicators and percentile curves, making it easier to plot and read; weight is labeled every 5 pounds with a line for every pound; stature is labeled every inch with a line for every quarter inch; age is labeled with each line representing 2 months.  When plotting on the 2-5 year (front) side of the chart you will determine the child's age and then plot the true age (round and plot to the nearest month).  On the 2 to 20 year BMI-for-age side you will plot the child's age rounded to the nearest quarter year. Effective October 1, 2007, these plotting methods must be used when plotting children 2-5 years of age.  The Health and Nutrition Assessment Handbook (HNAH) will be updated to reflect this information and sent in a later weekly updates message, and included in the next WOM revision.

    Attached is a sample growth chart to illustrate how to document and plot correctly for a child who is 3 years 3 months old.  Please contact the district nutritionist assigned for your agency if you have further questions.

  4. Fit WIC MO FFY 2007 Evaluation:  The due date for Fit WIC MO evaluations is fast approaching.  This is a reminder that each local WIC provider that participated in Fit WIC MO in FFY 2007 is asked to complete the attached Evaluation (Table 8).  Any agency that wrote a goal, objective, strategy or activity in the FFY 2007 LAP should complete the evaluation.  On the attached form, simply check the nutrition and physical activity goals that your agency selected in FFY 2007, report how many participants selected each goal and how many were successful at making the behavior change.  Then check which activity to support WIC staff or which community activity your agency selected and give a brief report of the results.  A few open-ended questions give you the opportunity to tell us what is working well for you and what barriers you are experiencing as you implement Fit WIC MO.  Return this electronically to Rita Arni at no later than September 30, 2007.
  5. Updated WIC Reference Sheets for the WIC Formulas, Foods, and Food Packages:  The WIC Reference Sheets for the WIC Formulas, Foods, and Food Packages have been updated and will be effective October 1, 2007.  Although all updates are listed on page 1 of the reference sheets, the following are important messages:
    •  Policy Change - Low Iron Formula:  The Missouri WIC program will no longer approve low iron formulas Effective October 1, 2007 to adhere with the American Academy of Pediatrics’ recommendations on low iron infant formula.
    • Direct Shipment:  The local WIC provider must contact the state nutritionist for a request for formula to be direct shipped to the agency when the formula requested is not available through the local WIC vendors.  The State WIC office is the only authority to have formulas direct shipped for the WIC Program.
    • Discontinuation of Formulas:  Please note on page 1 of the attached WIC Formula, Foods and Food Packages document, the formulas that are being discontinued by the formula manufacturers.

    Please share the updated reference sheets with your staff.  If you have any suggestions and/or questions, please contact Takako Tagami at 1-800-392-8209 or e-mail
  1. Microcuvette Delivery:  Thank you for completing the Microcuvette survey so quickly.  The Microcuvettes have been ordered from HemoCue.  They are expected to arrive in your agency the week of September 24th.  Those who needed a supply of Microcuvettes should expect to receive a shipment the week of September 24th through September 28th.  Upon receiving your shipment of Microcuvettes, please sign and date the packing slip from HemoCue.  Please fax the signed, completed packing slip to Christie Luadzers at 573-526-1470 by October 5, 2007.  If the number of Microcuvettes listed on the packing slip does not agree with the boxes you received, please call Christie Luadzers at 573-751-6204 or email her at  Some agencies appear to have sufficient supplies to last until we order again in the spring.  If you have questions, please feel free to contact Christie Luadzers.

2 to 5 (front side) example statement
2 to 20 (back side) example statement
Fit WIC Mo Evaluation Form
FRS FINAL 09-17-07