LARD Jan 10 Meeting Minutes - Public Health

o No specific USDA guidance but the State recommends
including your name, date and who you spoke to, and to
document in TWIST.
Action:
• The supplemental food section of the med doc in TWIST will be
changed to be consistent with the med doc form.
• Cheryl will seek guidance regarding role of RD in obtaining
clarification of diagnosis by verbal order.
• The original medical documentation workgroup will be reconvened. If
interested in assisting, contact Cheryl.
LARD survey results:
Group Discussion: Children with Special Health Care Needs (CSCHN)
• Prevalence of CSHCN has increased while at the same time:
o Availability of public health nurses has decreased.
o RD training opportunities for CSCHN have decreased.
• Scope of practice: mixed opinions whether WIC is set up to provide
nutrition services for CSCHN.
• Recent survey reflects lack of confidence regarding RD skills/training
to provide services to CSHCN.
• System issues: WIC is not funded, set up to provide high risk nutrition
services. At the same time, there is a lack of community RD services
for CSHCN. Result: high risk participants fall through the cracks
and/or end up in feeding clinics, hospitalized (tertiary care settings).
• Need to consider payment of services, development of partnerships
to allow WIC RDs (who are trained and interested) to see participants
outside of WIC.
Action:
Development of RD training plan workgroup within LARD, let Cheryl know if
you are interested in assisting.
Referrals for High Risk Participants
• The following counties are willing to share high risk referral protocols
and they will be sent out in email: Washington, Marion, Salud,
Umatilla-Morrow
• TWIST:
• Can provide a high risk report (CP800R) client
process/reports/nutrition education/high risk participant listing
• There is no connection between assignment of risk level and the
risk associated with scheduling preferences (on the family
summary screen).
LARD January 2010 meeting minutes 6