LARD Jan 10 Meeting Minutes - Public Health

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Group discussion: -The new food packages allow for more flexibility to adjust foods/formula amounts to meet the individual needs of the participant. -Medical documentation is not a prescription, it is a request/sharing of information and allows RDs to approve/not approve a formula depending on the underlying diagnosis/growth data. -Contacting the HCP allows the RD to negotiate/inform the HCP of the participant’s health status, growth pattern and coordinate care. -State NCs/Cheryl is available to support local agencies as needed regarding medical documentation, formula usage. Action: Recommend looking at growth rates of participants who are receiving a full food package and a full formula package for Pediasure to ensure appropriate weight gain. Providence medical formula: Discussed Providence shipping errors. Thanks to the hard work at the local agencies to correct this situation. State staff met with Providence Home Medical Equipment administration to discuss the problem and identify ways to correct errors on formula orders. Providence presented data on errors made by local agencies with the largest number of errors existing with use of the incorrect form, incomplete data provided (missing voucher numbers, phone numbers, and incomplete address or missing formula density –i.e. BKE 1.0 vs. 1.5) Group discussion: -Separation of duties: ensure that person assigning food package is not the same person printing vouchers. -Remind Providence to provide notification on back order status. -State WIC needs to be notified when a decision needs to be made regarding adjustments on vouchers. Action: • Update forms for Providence Home Medical Equipment (correct forms are dated 7/09). • Delete any old Providence forms. • Type information onto request forms (vs handwriting). • Write specifics on vouchers when needed (i.e. fiber, flavor) • Cheryl will send PHME formulary, Providence data on local agency orders. • Cheryl will remind Providence to notify local agencies of back order status. LARD January 2010 meeting minutes 4
Medical Formula brochure: The State is creating a brochure for vendors with formula graphics to ensure that the correct formula is sold. Group Discussion: -consider formatting that would allow for lamination of the material. -Many agencies show participants images of formulas on-line. -Reminder that it is against the WHO code to display formula information. Materials are to be kept out of view and shown to families as needed. -In addition to the brochure, formula descriptions on vouchers are being updated to ensure consistency and reduce errors at the grocery/pharmacy. Medical Documentation Workgroup: Shared comments, suggestions from local agencies regarding medical documentation form changes. Recommendations from LARD members: o Clarify length of authorization: 12 calendar months vs. 12 month age of child o Supplemental foods section-include wording to indicate food package guidance when infant turns 7 months of age. o Add family phone number in the staff section on the form. o Add expiration date to the bottom of the form. o Consideration: How are agencies filing the forms-by the month of expiration, month received, by name? Identify the pros & cons of the filing methods. o What is stated in TWIST and on the med doc are not in the same sequence. Prefer that the med doc form not change. o Make small changes, not major changes as HCPs are just now becoming familiar with the changes Group Discussion: • Soy beverage-lactose intolerance vs. severe lactose intolerance: o Lactose intolerance is not a qualifying condition for soy beverage o Start with lactose free milk but if nothing else is working, what is the next step? o Some HCPs have been adamant that soy beverage be issued for constipation. o Others mark vegan and then issue milk and eggs. o Local agencies are needing clarification on RD’s role for accepting verbal order for clarification of diagnosis for issuance of soy beverage. • Documentation needed when taking verbal orders: LARD January 2010 meeting minutes 5
Page 1 and 2: Local Agency Registered Dietitians
Page 3: 2. Peer counseling funding (Mary Ka
Page 7 and 8: Action: • Cheryl will forward ref

LARD Jan 10 Meeting Minutes - Public Health

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