216-RICR-20-05-3. WIC Program (version Amendment, 02/17/2002 to 02/26/2003)

Goals 2002 Section I Preliminary Information Section I - 1 SECTION I Preliminary Information Refer to WIC Procedure Manual Section 100 WIC Operations Manual Section 1 Goals 2002 Section I Preliminary Information Section I - 2 RHODE ISLAND DEPARTMENT of HEALTH WIC PROGRAM LOCAL AGENCY ADMINISTRATON and LOCAL WIC CLINICS Local WIC Agency Administration Local WIC Agency Clinics Mr. Ray Lavoie, Director Ms. Tanya Solberg, WIC Coordinator/Nutritionist Blackstone Valley Community Health Care, Inc. 42 Park Place Pawtucket, RI 02860 John J. Cunningham Health Center 42 Park Place Pawtucket, RI 02860 (401) 722-0082 BVCHC Health Center 9 Chestnut Street Central Falls, RI 02863 (401) 724-7134 Ms. Eileen Lee, MD Acting Executive Director Ms. Kerry Gregory, WIC Coordinator/Nutritionist Chad Brown Health Center 285A Chad Brown Street Providence, RI 02908 (401) 831-0020 Chad Brown Health Center 285A Chad Brown Street Providence, RI 02908 (401) 831-0020 Ms. Joanne McGunagle, Executive Director Comprehensive Community Action Program, Inc. 311 Doric Avenue Cranston, RI 02908 (401) 467-9610 Ms. Kathy Higgins, WIC Coordinator/Nutritionist Family Health Services of Cranston 1090 Cranston Street Cranston, RI 02920 (401) 946-4650 Family Health Services of Cranston 1090 Cranston Street Cranston, RI 02920 (401) 946-4650 Cranston Satellite 191 MacArthur Blvd. Cranston, RI Goals 2002 Section I Preliminary Information Section I - 3 Ms. Maria Montanaro, Chief Executive Officer Ms. Jennifer Clough, WIC Coordinator Health Center of South County WIC Program One River Street Wakefield, RI 02879 (401) 782-0855 Health Center of South County WIC Program One River Street Wakefield, RI 02879 (401) 782-0855 Bayside Family Healthcare, Inc. 308 Callahan Road North Kingstown, RI 02852 Mr. Dennis Roy, Chief Executive Officer Ms. Beth Sapolosky, WIC Coordinator/Nutritionist New Visions for Newport County, Inc. Newport Community Health Center WIC Program 19 Broadway Newport, RI 02840 (401) 847-7821 New Visions for Newport County, Inc. Newport Community Health Center WIC Program 19 Broadway Newport, RI 02840 (401) 847-7821 New Visions for Newport County, Inc. James F. Silvia Health Center WIC Program 1048 Stafford Road Tiverton, RI 02878 (401) 625-5134 Florence Gray Multi Purpose Center 1 York Street Newport, RI 02840 (401) 848-6682 Mr. Merrill Thomas, Executive Director Ms. Lynda Greene, WIC Coordinator Providence Community Heath Centers, Inc. 375 Allens Avenue Providence, RI 02905 (401) 444-0400 Allen Berry Health Center WIC Program 202 Prairie Avenue Providence, RI 02907 (401) 444-0570 x 27 Capitol Hill Health Center WIC Program 40 Candace Street Providence, RI 02908 (401) 444-0550 x 22 Central Health Center WIC Program 239 Cranston Street Providence, RI 02907 (401) 444-0580 x 23 Goals 2002 Section I Preliminary Information Section I - 4 Fox Point Health Center WIC Program 550 Wickenden Street Providence, RI 02903 (401) 444-0530 Olneyville Health Center WIC Program 100 Curtis Street Providence, RI 02909 (401) 444-0540 x 28 Mr. H. John Keimig, President St. Joseph Hospital 200 High Service Avenue North Providence, RI 02904 (401) 456-3080 Ms. Susan Vieira, LDN, WIC Coordinator/Nutritionist St. Joseph Health Center 21 Peace Street Providence, RI 02907 (401) 456-4069 St. Joseph Health Center 21 Peace Street Providence, RI 02907 (401) 456-4069 Mr. Dennis M. Roy, Executive Director Ms. Beth Sapolsky, Coordinator/Nutritionist Self-Help, Inc. East Providence Community Health Center WIC Program 100 Bullocks Point Avenue Riverside, RI 02915 (401) 437-1007 East Providence Community Health Center WIC Program 100 Bullocks Point Avenue Riverside, RI 02915 (401) 437-1007 Warren Health Center 1 Joyce Street Warren, RI Goals 2002 Section I Preliminary Information Section I - 5 Mr. Joseph R. DeSantis, Executive Director Ms. Karen Schiltz, LDN, WIC Coordinator/Nutritionist Tri-Town Economic Opportunity Committee Tri-Town Health Center WIC Program 1126 Hartford Avenue Johnston, RI 02919 (401) 351-2750 Tri-Town Health Center WIC Program 1126 Hartford Avenue Johnston, RI 02919 (401) 351-2750 Northwest WIC Satellite 166 Main Street Pascoag, RI 02859 (401) 567-0510 Ms. Jeanne Gattegno, Executive Director Westbay Community Action, Inc. 218 Buttonwoods Avenue Warwick, RI 028867541 (401) 732-4660 Ms. Jayce Winiarski, WIC Program Manager Nutritionist Westbay Community Action, Inc WIC Program 205 Buttonwoods Avenue Warwick, RI 02886 (401) 732-4660 Westbay Community Action, Inc WIC Program 205 Buttonwoods Avenue Warwick, RI 02886 (401) 732-4660 West Warwick WIC Satellite 53 Providence Street West Warwick, RI 02893 826-3230 Mr. Thomas Parris, President Ms. Doreen Chin Pratt, MS, RD, Director of Nutrition Services/WIC Coordinator Women and Infants' Hospital WIC Program 2 Dudley Street WPCC Nutrition Services - Suite 565 Providence, RI 02905-2401 (401) 274-1122 ext. 2768 Women and Infants' Hospital WIC Program 2 Dudley Street WPCC Nutrition Services – Suite 565 Providence, RI 02905-2401 (401) 274-1122 ext. 2768 Mr. Ernest Balasco, LICSW, Executive Director Mr. Douglas Jones, WIC Coordinator/Nutritionist Wood River Health Services WIC Program 823 Main Street Hope Valley, RI 02832 (401) 539-2461 Wood River Health Services WIC Program 823 Main Street Hope Valley, RI 02832 (401) 539-2461 Goals 2002 Section I Preliminary Information Section I - 6 Section I Selection of Local Agencies Goal: To ensure that local agencies are selected and funded in accordance with the need for Program benefits in an area, participant access, coordination of care and the efficient and effective utilization of nutrition and program services (NSA) funds. Recent Trends Enhanced collaboration between the WIC Program and “sister” health / social service programs (ie, Lead, Immunization, Ritecare {medicaid}) is continuing to expand. Although targeted funding for these activities is lagging behind, RI WIC is focusing on use of Kidsnet (RI’s public health preventive services database) to monitor and target cross program initiatives. Rhode Island's RIte Care Program (RITECARE), implemented in 1994, brought radical restructuring to the health care system for low income mothers and children: • All eligible pregnant women and children up to age six are covered for comprehensive preventive and corrective health care. • The care is rendered in the context of a chosen primary provider and health plan, with restrictions on using out of plan services. • Twelve current WIC providers are affiliated with one of the three remaining *competing RITECARE plans. • Financial eligibility was expanded to include almost 10,000 women and children between 185 and 250 percent of poverty. • This additional group is adjunctively income eligible for WIC. As of December 2000, 93% of WIC participants were insured, with an additional 4.2% referred for health insurance. Objective 1: Evaluate anticipated changes in the Rite Care Eligibility criteria related to potential impact on determination of adjunctive eligibility. Delegation of Contractual Authority The Director of the Department of Administration (DOA) is the individual with the authority to enter into binding agreements on behalf of the State. Delegated Authority allows HEALTH to procure direct service providers (such as WIC local agencies). Under delegated authority the Department must be able to demonstrate that providers selected are those which most efficiently and/or effectively deliver services and/or make maximum use of Department resources through lowered cost or increased productivity. Objective 1: In the event the delegation of authority is canceled by either Department, the Goals 2002 Section I Preliminary Information Section I - 7 DOH or DOA will issue a Request for Proposals for WIC local agency services. In that event, HEALTH would likely request the contracts be multi year, annually renewable. Additional WIC Program Services and Service and Performance Objectives In recent years, the growing savings from food cost containment supported significant participation increases. Continued savings could eventually accommodate an increase of 3,000 - 4,000 participants (although a new Infant Formula Rebate starting October 1, 2001, will impact this area). Objective 1: Investigate if additional WIC sites are needed to fully utilize funding. HEALTH estimates these site needs: 1. One full time site offering a multitude of services 2. Three part-time satellite sites accessible to unserved suburban pockets of need Congressional directives and Federal regulations have defined a number of areas in which the WIC Program is to conduct additional activities (e.g. information and referral, health care coordination, immunizations, substance abuse education and voter registration). At the same time allied programs are receiving similar instructions to more closely coordinate their services with WIC. The underlying objectives of these changes include the accessibility of these public benefits to potential clients through outreach, more accessible clinic operations and closer coordination and maximizing the preventive or restorative effects of the various programs by coordination among services which can compliment and enhance each other. In light of federal and public health objectives, HEALTH has identified the following areas to be addressed in structuring the local WIC services system: Objective 1: Ensure prompt access to services 1. The Program must make available evaluation and receipt of benefits to non- breastfed infants in a much shorter time span, including ability to respond on a crisis intervention basis. 2. The Program's preventive effectiveness has been shown to be greatest when pregnant women receive benefits as early in pregnancy as possible. Any delay in responding to a request from a pregnant woman in effect undermines the Program's effectiveness. 3. Accessible hours for the working eligible. Congress has mandated that WIC services be available during hours in which the working eligible (over two thirds of WIC families) can apply for the Program without interfering with their jobs. Goals 2002 Section I Preliminary Information Section I - 8 4. Prompt enrollment of other high risk individuals. Objective 2: Ensure coordination of WIC services with on-site health care services, especially to increase immunization rates for WIC children. HEALTH must recognize changes in location of health care services to WIC participants and potential eligibles. Efforts must be made to increase access to WIC services at all sites where such persons are receiving health care. Objective 3: Coordinate simplified access to multiple services at one appointment ("one stop shopping"). Objective 4: Increase and enhance breastfeeding support and promotion. Objective 5: Monitor, support and ensure the quality of delivery of WIC services. Objective 6: Ensure compliance with Program rules and requirements. Reduce Imbalances in Ratios of Enrollment to Need (see Affirmative Action Plan) Objective 1: Continue efforts to reduce disparities between high and low percentages of met need around the State through continual State office review of: 1. Caseload and allocation adjustment, 2. Local agency performance in high risk identification, caseload maintenance, 3. Establishment of local agency satellite sites in areas of particularly high unmet needs, 4. State and local outreach activities. Objective 2: Review the contracting process as related to: 1. Continued variations in the percent of need met where some communities have remained at more than ten percent below the statewide need met average over the course of several years. 2. Despite substantial success in targeting benefits to high risk eligibles (more than eighty percent of current enrollments) such items as clinic location, additional satellite clinics, and local outreach need to be further evaluated to further improve such targeting. Other Considerations Goals 2002 Section I Preliminary Information Section I - 9 Objective 1: Continue monitoring the impact of Ritecare on the WIC provider network. Eleven of the thirteen current WIC local agencies are members of a single competitive Ritecare provider plan . This means that perhaps half of the WIC clients at an agency may be members of its plan and half not. Objective 2: Continue monitoring the impact of RITECARE and its effects on the ability of the current WIC network of local agencies to maintain services to all, both community health plan members and non-member WIC clients. HEALTH will need to assess whether any current WIC local agency is unable to maintain services due to RITECARE non-participation or RITECARE restrictions. Objective 3: The Program needs to be ready to respond to continued expansion opportunities, through either federal or state cost saving or funding initiatives. Determination will have to be made whether the current network is capable of meeting its program expansion goals. Objective 4: If the current network is adequately providing services, then a further review would be made as to whether there is any compelling need or gain to seek other providers through other RITECARE plans. If the current network is not sufficient to continue to provide WIC services to all eligible clients for which the Program has funds, or if there is any other compelling need to seek other providers then the HEALTH would perform a feasibility study of the benefits and drawback to additional providers, especially in relation to client access and caseload expansion needs. This review will consider: 1. The ability of other providers to provide quality WIC nutrition, eligibility and coordination and outreach services. 2. Evaluate different provider models to determine if any, all or which can provide services which equally or better meet the needs of the Rhode Island WIC Program and actual and potential clients. Caseload Allocation and Adjustment Goal: To ensure service to the maximum number of women and children allowed by available funds, while protecting the Program from overspending. Objective 1: Continue to utilize accurate, reliable, and quickly accessible measures of utilization of available funds and caseload. This will be accomplished through applying better planning techniques to the improved data collection, storage, and reporting capabilities of the ADP System. Measures being developed include: 1. Developing measures of local agency performance and indicators of future capability, Goals 2002 Section I Preliminary Information Section I - 10 2. Improved measures of relative need in each service area, 3. Automated on-going caseload tracking and control tools. Goal: To ensure that all agencies are providing services to the number of participants authorized or directed by the State agency, to the extent permitted by federal funding. It is essential that locals maintain caseload at the assigned level and utilize administrative funds at an appropriate rate. Unutilized funds must be directed on a timely basis toward local agencies which can utilize them. Objective 1: To take such temporary actions and adjustments as are necessary to efficiently manage funds in order to avoid over or under spending. Goals 2002 Section I Preliminary Information Section I - 11 Affirmative Action Plan Goal: To allocate additional slots to areas based on need and ability to utilize additional caseload. Evaluation: Rhode Island is currently providing WIC benefits to the eligible population in all the state's thirty-nine cities and towns and will continue to do so as long as federal funding permits. Potentially Eligible WIC Population The population of Rhode Island potentially eligible to participate in the WIC Program was estimated from demographic and economic data available on a city and town basis. Vital Records data were used to estimate by city and town the number of women, infants, and children. A five-year average of the most recent resident live births was used. The number of infants was estimated as the average number of live births to residents of Rhode Island. The number of children one through four was estimated as the average number of live births to residents of Rhode Island times four. The number of pregnant women was estimated as 0.75 times the average number of live births (note that multiple births were controlled in the estimate). The number of postpartum and breastfeeding women was calculated as 0.5 times the average number of live births (as was the number of pregnant women). These cohorts were summed to produce an estimate of the population by city and town with the demographic characteristics required for enrollment in WIC. The 1990 census data of the number of related children under 5 under 185% of the OMB poverty level by city and town were used. These numbers were divided by the five-year average of live births to determine the percent financially eligible for the program. This percentage was multiplied by the number demographically eligible to give an estimate for each city or town of the number of individuals residing in each who have both the demographic and income characteristics required for participation in WIC (Table I). Health Indicator The average (five-years) percents of low birth weight infants (less than 2500 grams), of spontaneous fetal mortality, and of teenage mothers, by city and town were utilized. The multiple year average percentage allows for a control of wide statistical fluctuations which may occur when dealing with 500 or fewer events (Table II). Statewide Parity Rhode Island receives funding (federal grant and infant formula rebates) for and provides service to an estimated 76 percent of its WIC eligible population. Locality analysis of enrolled participants indicates that service levels vary significantly between cities and towns from over 100 percent of the eligible population being served in some towns (indicating a potential problem with the basic poverty data) to 5 percent of the eligible population on Block Island. Thirty-four percent (34%) of the total WIC eligible population resides in the City of Providence. Goals 2002 Section I Preliminary Information Section I - 12 Following previous allocation formulas, 39 percent of the total caseload (as of June, 1997) was designated to the four local agencies (8 sites) in Providence. In FY'80 the state's AAP first introduced the expansion goal of Statewide Parity. For FY'2002, the AAP in its expansion criteria again incorporates this goal. Additional slots will be allocated to local sites in relation to the expansion rank of the cities and towns served, the state mean, and the size of the needy population (Tables I, IV, VI). Unfilled slots shall be counted as allocated. Service Areas - Market Share Concept In Rhode Island's WIC Program, residence is defined as state residency. The service areas of locals are generally consistent with the geographic location of the agency. Eligible participants are encouraged to enroll in the WIC Program at the site where they and their families receive medical care, and at a site that is easily accessible to them. Individuals, nevertheless, may apply for and receive benefits at an agency of their choice, where there is an opening. Some local sites that provide specialized medical care and unique services, moreover draw eligibles from many of Rhode Island's communities. In order to define service areas this plan incorporates two concepts: 1. Market Sharing A local agency is considered as impacting or eligible to receive allocations targeted to increase participation in a particular city or town if it serves a minimum of 10 percent of the enrolled population of the city or town. For the analysis of the local agency's impact on each community served, the census tracting of local agency caseloads was performed to indicate cities and towns served by each local and determine the percentage of caseload composed by this distribution (Tables III and V). 2. Normative Concept The use of the Normative Concept involves the utilization of traditional demographically designed target populations in order to stabilize the areas. The application of this concept, it is hoped, will control the normative aspects of market sharing, such as the natural numerical advantage enjoyed by agencies with large caseloads, or possible competition among local agencies for participants on the basis of residency. Table V indicates current assignment of service areas. 4. Realignment of Service Areas Objective 1: If an area has been underserved by more than 750 potential eligibles or 10% of the statewide average, in accordance with the AAP, in the current Plan and for two of the past three Plans, the State Agency may solicit or accept proposals from other agencies to provide service which is likely to significantly increase the number or percent served in the defined area. Goals 2002 Section I Preliminary Information Section I - 13 Future Allocations Table VI shows the final ranking for expansion by city and town. Objective 1: Caseload expansions will be allocated in accordance with need and local agency ability to provide service. Methods - The following criteria will be applied in implementing the Affirmative Action Plan. 1. Current or previous unutilized caseload at an agency shall be considered before allocating it additional slots. 2. The most current economic and health data, if feasible, will be incorporated to update the Affirmative Action tables. 3. Recognition will be given to each agency's willingness and capacity to expand operations. Agencies desiring increased caseload may be required to submit a plan of the methods they will utilize to ensure that the additional caseload is enrolled. 4. The need rankings and other measures of need in the Affirmative Action Plan will be applied. In addition the census tracts identified as those with the highest need (Factor Analysis study of Buechner, Scott, Smith, et al.) will be viewed for effective penetration. 5. Preliminary and final identification of each local agency's estimated proportion of increased caseload will be made. 6. Enrollment and spending will be monitored and the expansion plan may be adjusted as warranted. Goals 2002 Section I Preliminary Information Section I - 14 % Unserved Estimated WIC WIC Above WIC WIC Eligible Eligible State Eligible Eligible Enrolled Unserved Mean Unserved Barrington 211 30 85.8% 56.1% 181 Bristol 403 217 46.2% 16.4% 186 Burrilville 427 212 50.4% 20.6% 215 Central Falls 1,642 1,487 9.4% 0.0% 155 Charlestown 105 94 10.5% 0.0% 11 Coventry 592 304 48.6% 18.9% 288 Cranston 1,753 839 52.1% 22.4% 914 Cumberland 554 258 53.4% 23.7% 296 East Greenwich 241 60 75.1% 45.4% 181 East Providence 1,205 742 38.4% 8.7% 463 Exeter 13 53 -307.7% 0.0% -40 Foster 10 52 -420.0% 0.0% -42 Glocester 293 34 88.4% 58.7% 259 Hopkinton 33 103 -212.1% 0.0% -70 Jamestown 96 11 88.5% 58.8% 85 Johnston 598 326 45.5% 15.8% 272 Lincoln 360 156 56.7% 26.9% 204 Little Compton 63 5 92.1% 62.3% 58 Middletown 694 220 68.3% 38.6% 474 Narragansett 71 84 -18.3% 0.0% -13 Newport 1,332 653 51.0% 21.3% 679 New Shoreham 39 1 97.4% 67.7% 38 North Kingstown 370 232 37.3% 7.6% 138 North Providence 262 358 -36.6% 0.0% -96 North Smithfield 59 35 40.7% 11.0% 24 Pawtucket 3,198 2,813 12.0% 0.0% 385 Portsmouth 249 97 61.0% 31.3% 152 Providence 11,280 9,142 19.0% 0.0% 2,138 Richmond 24 70 -191.7% 0.0% -46 Scituate 75 74 1.3% 0.0% 1 Smithfield 174 100 42.5% 12.8% 74 South Kingstown 402 225 44.0% 14.3% 177 Tiverton 260 98 62.3% 32.6% 162 Warren 156 121 22.4% 0.0% 35 Warwick 1,613 854 47.1% 17.3% 759 Westerly 648 366 43.5% 13.8% 282 West Greenwich 38 21 44.7% 15.0% 17 West Warwick 777 718 7.6% 0.0% 59 Woonsocket 2,566 1,847 28.0% 0.0% 719 32,886 23,112 29.7% = the State Mean Of Unserved WIC Eligible Population 9,774 =Total # of Unserved WIC Eligible Population Table 1 Number and Percent of WIC Eligible Population Served by Each City and Town Goals 2002 Section I Preliminary Information Section I - 15 Less Than 185% of Poverty Level Fetal Mortality Low Birth Weight Teen Mothers Combined AAP Indicators Score Rank Barrington 8.0% 4% 5.4% 1.0% 17.9 39 Bristol 16.0% 4% 6.1% 7.0% 32.9 23 Burrilville 17% 6% 4.4% 7.0% 34.6 16 Central Falls 47% 8% 7.9% 17.0% 79.6 1 Charlestown 14% 15% 5.1% 4.0% 38.0 11 Coventry 15% 6% 6.1% 6.0% 33.0 22 Cranston 19% 5% 6.3% 6.0% 36.5 13 Cumberland 13% 7% 4.2% 5.0% 29.3 26 East Greenwich 9% 10% 4.7% 0.0% 23.8 35 East Providence 22% 10% 6.6% 8.0% 46.1 8 Exeter 18% 0% 5.3% 4.0% 27.3 32 Foster 14% 8% 6.5% 0.0% 28.1 29 Glocester 16% 6% 6.8% 0.0% 28.5 28 Hopkinton 15% 10% 5.5% 6.0% 36.1 14 Jamestown 17% 0% 4.0% 0.0% 21.0 36 Johnston 20% 3% 6.4% 4.0% 33.8 17 Lincoln 17% 7% 5.0% 5.0% 33.7 18 Little Compton 14% 6% 6.2% 0.0% 26.4 33 Middletown 18% 8% 4.1% 6.0% 35.9 15 Narragansett 22% 5% 4.1% 2.0% 33.2 21 New Shoreham 68% 0% 3.2% 0.0% 71.2 3 Newport 25% 7% 6.0% 14.0% 52.2 6 North Kingstown 13% 9% 5.2% 6.0% 33.4 20 North Providence 20% 6% 6.4% 6.0% 38.7 10 North Smithfield 12% 8% 5.3% 4.0% 29.2 27 Pawtucket 30% 6% 7.2% 13.0% 56.0 5 Portsmouth 14% 6% 4.4% 4.0% 28.1 30 Providence 43% 9% 7.9% 16.0% 76.1 2 Richmond 10% 8% 2.3% 7.0% 27.7 31 Scituate 11% 7% 7.3% 0.0% 25.6 34 Smithfield 10% 4% 4.4% 1.0% 19.8 37 South Kingstown 15% 7% 4.5% 5.0% 31.3 25 Tiverton 17% 9% 5.6% 5.0% 36.9 12 Warren 18% 3% 5.7% 7.0% 33.5 19 Warwick 17% 5% 4.9% 6.0% 32.9 24 West Greenwich 12% 0% 5.4% 2.0% 19.4 38 West Warwick 21% 9% 7.2% 11.0% 48.0 7 Westerly 18% 7% 6.0% 8.0% 38.8 9 Woonsocket 33% 7% 7.1% 16.0% 62.7 4 State Mean 19.4% 6% 5.6% 5.6% Table II Ranking of Need Based on 5 Year Average of Select Indicators Goals 2002 Section I Preliminary Information Section I - 16 Women & Infants Hospital St Joseph Hospital Self Help Health Center Tri-Town Health Center Westbay CAP Health Center of South County Wood River Health Center BVCHC Health Center Chad Brown Health Center Cranston Health Center Thundermis t Health Center New Visions Health Center PHC Health Centers (%) (%) (%) (%) (%) (%) (%) (%) (%) (%) (%) (%) (%) Barrington 0 0 93 4 0 0 0 0 0 4 0 0 0 Bristol 2 1 80 0 0 0 0 0 0 0 0 14 4 Burrilville 0 0 0 87 1 0 0 0 0 0 10 0 1 Central Falls 2 0 0 0 0 0 0 94 0 0 0 0 4 Charlestown 0 0 0 0 0 59 41 0 0 0 0 0 0 Coventry 1 0 1 2 53 0 0 0 0 41 0 0 1 Cranston 6 3 0 4 4 0 0 0 1 64 0 0 16 Cumberland 3 0 0 1 1 0 0 58 0 1 34 0 2 East Greenwich 3 0 0 0 40 33 8 0 0 8 0 0 8 East Providence 3 1 76 1 0 0 0 2 1 1 0 0 16 Exeter 0 0 0 0 4 60 32 0 0 4 0 0 0 Foster 0 0 0 95 0 0 0 0 0 0 5 0 0 Glocester 0 0 0 83 0 0 0 0 0 0 14 0 0 Hopkinton 0 0 0 0 1 6 93 0 0 0 0 0 0 Johnston 2 1 1 82 2 1 0 1 1 5 1 0 5 Lincoln 1 0 1 4 0 0 0 38 2 0 53 0 1 Little Compton 0 0 0 0 0 0 0 0 0 0 0 100 0 Middletown 0 0 0 0 0 0 0 0 0 0 0 100 0 Narragansett 0 0 0 2 2 93 0 0 0 1 0 1 0 Newport 0 0 0 0 0 1 0 0 0 0 0 98 0 New Shoreham 0 0 0 0 0 100 0 0 0 0 0 0 0 North Kingstown 0 0 0 1 6 89 0 0 0 1 0 0 0 Table III Percent of Service by WIC Agencies By City or Town of Participant Residence Goals 2002 Section I Preliminary Information Section I - 17 Women & Infants Hospital St Joseph Hospital Self Help Health Center Tri-Town Health Center Westbay CAP Health Center of South County Wood River Health Center BVCHC Health Center Chad Brown Health Center Cranston Health Center Thundermis t Health Center New Visions Health Center PHC Health Centers (%) (%) (%) (%) (%) (%) (%) (%) (%) (%) (%) (%) (%) North Providence 8 2 1 61 0 0 0 10 4 1 0 0 14 North Smithfield 3 0 0 3 0 6 0 0 0 0 89 0 0 Pawtucket 2 1 1 1 0 0 0 86 1 1 1 0 7 Portsmouth 0 0 3 0 0 0 0 0 0 0 0 97 0 Providence 12 13 1 2 0 0 0 2 5 3 0 0 62 Richmond 0 0 0 0 7 6 87 0 0 0 0 0 0 Scituate 1 0 0 63 8 0 0 0 0 25 0 0 3 Smithfield 3 1 0 68 0 0 0 3 2 0 22 0 1 South Kingstown 0 0 0 0 0 99 1 0 0 0 0 0 0 Tiverton 1 0 1 0 0 0 0 0 0 0 0 98 0 Warren 3 0 91 0 0 0 1 3 0 0 0 2 1 Warwick 3 1 1 2 84 0 0 1 0 4 0 0 3 Westerly 1 0 0 0 1 6 92 0 0 0 0 0 0 West Greenwich 0 0 0 0 32 0 16 0 0 52 0 0 0 West Warwick 1 0 0 1 82 2 1 0 0 11 0 0 2 Woonsocket 0 1 0 0 0 0 0 2 0 0 96 0 0 Table III – continued Percent of Service by WIC Agencies By City or Town of Participant Residence Goals 2002 Section I Preliminary Information Section I - 19 Combined AAP Indicators - Table II % WIC Eligible Unserved - Table I Need Index Rank Barrington 17.9 85.8 1,536 20 Bristol 32.9 46.2 1,520 21 Burrilville 34.6 50.4 1,744 13 Central Falls 79.6 9.4 748 29 Charlestown 38 10.5 399 31 Coventry 33 48.6 1,604 16 Cranston 36.5 52.1 1,902 8 Cumberland 29.3 53.4 1,565 17 East Greenwich 23.8 75.1 1,787 10 East Providence 46.1 38.4 1,770 11 Exeter 27.3 -307.7 -8,400 38 Foster 28.1 -420 -11,802 39 Glocester 28.5 88.4 2,519 3 Hopkinton 36.1 -212.1 -7,657 37 Jamestown 21 88.5 1,859 9 Johnston 33.8 45.5 1,538 19 Lincoln 33.7 56.7 1,911 7 Little Compton 26.4 92.1 2,431 5 Middletown 35.9 68.3 2,452 4 Narragansett 33.2 -18.3 -608 34 New Shoreham 71.2 97.4 6,935 1 Newport 52.2 51 2,662 2 North Kingstown 33.4 37.3 1,246 24 North Providence 38.7 -36.6 -1,416 35 North Smithfield 29.2 40.7 1,188 25 Pawtucket 56 12 672 30 Portsmouth 28.1 61 1,714 14 Providence 76.1 19 1,446 22 Richmond 27.7 -191.7 -5,310 36 Scituate 25.6 1.3 33 33 Smithfield 19.8 42.5 842 27 South Kingstown 31.3 44 1,377 23 Tiverton 36.9 62.3 2,299 6 Warren 33.5 22.4 750 28 Warwick 32.9 47.1 1,550 18 West Greenwich 19.4 44.7 867 26 West Warwick 48 7.6 365 32 Westerly 38.8 43.5 1,688 15 Woonsocket 62.7 28 1,756 12 Table IV Calculation and Ranking of Need Indicator by City and Town Goals 2002 Section I Preliminary Information Section I - 20 Agency Need Index Communities Services Blackstone Valley CHC 748 Central Falls 1,565 Cumberland 1,911 Lincoln 672 Pawtucket Chad Brown Health Center 14,446 Providence Cranston Cap 1,604 Coventry 1,902 Cranston Health Center of South County 399 Charlestown 1,787 East Greenwich -8,400 Exeter 1,859 Jamestown -608 Narragansett 6,935 New Shoreham 1,246 North Kingstown 1,377 South Kingstown New Visions for Newport 1,859 Jamestown 2,431 Little Compton 2,452 Middletown 2,662 Newport 1,714 Portsmouth 2,299 Tiverton Providence Ambulatory Health Care 1,902 Cranston Foundation, Inc. (PAHCF) 1,787 East Greenwich 1,770 East Providence -1,416 North Providence 1,446 Providence Self-Help, Inc. 1,536 Barrington 1,520 Bristol 1,770 East Providence 750 Warren Table V WIC Local Agency Current Service Areas Goals 2002 Section I Preliminary Information Section I - 21 Agency Need Index Communities Services St. Joseph Hospital 1,446 Providence Thundermist Health Associates, Inc 1,911 Lincoln 1188 North Smithfield 842 Smithfield 1,756 Woonsocket Tri- Town Economic Opportunity 1,744 Burrillville Committee 1,565 Cumberland -11,802 Foster 1,538 Johnston -1,416 North Providence 33 Scituate 842 Smithfield 2,519 Glocester Westbay Community Action,Inc. 1,604 Coventry 1,787 East Greenwich 1,550 Warwick 867 West Greenwich 365 West Warwick Women and Infants' Hospital 1,536 Barrington 1,446 Providence Wood River Health Services 399 Charlestown -8,400 Exeter -7,657 Hopkinton -5,310 Richmond 867 West Greenwich 1,688 Westerly STATE MEAN 801 Table V - continued WIC Local Agency Current Service Goals 2002 Section I Preliminary Information Section I - 22 Affirmative Action Data WIC Estimated Rhode Island Participation by Category Average for FY ’01 * Category # of Estimated WIC Eligibles # of Estimated WIC Participants Women 6,577 4,274 Infants 5,262 6,356 Children 21,047 12,482 Total 32,886 23,112 *Sources of data for all tables: United States Census Bureau - 1990 Census HEALTH - Division of Vital Statistics - Vital Statistics Reports 1991- 1995 HEALTH – WIC Program Participation Report – September 2001 Commodities Supplemental Food Programs The CSFP does not operate in Rhode Island State Systems Development Initiative The Division of Family Health, HEALTH, has received a State Systems Development Initiative (SSDI) grant to improve the accessibility and coordination of maternal and child services in the state. As a unit of the Division of Family Health serving much of the same population of other MCH programs, the Rhode Island WIC Program will endeavor to help to carry out the objectives of SSDI and to make them a part of its operations also. The SSDI project focuses on parent led assessment of the needs of young families, and the reasons for not participating in a range of preventive programs including WIC, Early Intervention, immunizations, Medicaid, etc. Special attention will be given to families who are "lost to follow- up". A detailed inventory of all preventive services available will be compiled and a survey of all preventive service providers will be conducted. This data will be evaluated to develop new models of integrated outreach and follow-up The project, called "Pulling It All Together With Parents As Partners" (previously implemented in Goals 2002 Section I Preliminary Information Section I - 23 Woonsocket and Central Falls) has now shifted to Providence which has substantial risk of adverse reproductive and child developmental outcomes. Disaster Coordination and Planning Goal: In the event of a disaster which disrupts food distribution, utilities, transportation, building security, communications or computer operations, to assure continuity of access to supplemental foods, certification services, operation of accountability systems, and information and referral response, and to extend services to newly eligible persons related to the disaster. Objective 1: Continue working relationships with the HEALTH Disaster Coordinator and Emergency Response Primary Contacts and the State Emergency Management Agency to clarify WIC's roles, needs and communications Evaluation: WIC was defined as a key HEALTH Program resulting in inclusion in Y2K Planning efforts. HEALTH refined its Disaster Plan, integrating WIC procedures into the process. The State WIC Office completed an assessment of the QWIC System needs for security and continuity of access, physical, operating system, network and software aspects While Y2K was a “non-event”, procedures developed were implemented when a major WIC provider went on strike and the procedures were implemented. Lessons learned from the month long strike were reviewed. Objective 2: By February, 2002, conduct a Disaster Procedures Training Workshop for all personnel Objective 3: Produce a Disaster Procedures section of the State Operations Manual and the Local Agency Procedures Manual Objective 4: By June, 2002, conduct a Disaster Drill at the State and all local WIC agencies