cascades 2020 spring release...cascades spring 2020 release . child certification s extend to the...

Cascades Spring 2020 Release Training Materials

Washington State WIC Program Implementation date: June 1, 2020

HEALTH ALWAYS WORKING FOR A SAFER AND HEALTHIER WASHINGTON

Washington State Department of

Health

Cascades Spring 2020 Release

WIC Nutrition Program doesn’t discriminate. In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, sex, disability, age, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA.

Persons with disabilities who require alternative means of communication for program information (e.g. Braille, large print, audiotape, American Sign Language, etc.), should contact the Agency (State or local) where they applied for benefits. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than English.

To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at: http://www.ascr.usda.gov/complaint_filing_cust.html, and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by:

Mail: U.S. Department of Agriculture Office of the Assistant Secretary for Civil Rights 1400 Independence Avenue, SW Washington, D.C. 20250-9410

Email: [email protected]

Fax: (202) 690-7442

This institution is an equal opportunity provider. Washington State WIC Nutrition Program doesn’t discriminate.

To request this document in another format, call 1-800-841-1410. Deaf or hard of hearing customers, please call 711 (Washington Relay) or email [email protected].

DOH 962-1206 May 2020

http://www.ocio.usda.gov/sites/default/files/docs/2012/Complain_combined_6_8_12.pdf

http://www.ocio.usda.gov/sites/default/files/docs/2012/Complain_combined_6_8_12.pdf

http://www.ascr.usda.gov/complaint_filing_cust.html

mailto:[email protected]

mailto:[email protected]


Here’s what you’ll find in this document:

Cascades Spring 2020 Release .................................................................................................................. 3

Pregnant Participant Transfer Into State .................................................................................................4

Child Certifications Extend to the End of the Month They Turn 5 .........................................................5

Temporary Certification End Date Fixes...................................................................................................6

Clinic Master Calendar Memory Issue......................................................................................................7

Risk Factor Changes ................................................................................................................................... 7

Table of Risk Factor Changes .................................................................................................................... 8

Washington State Department of Health WIC Program 2



The Cascades spring 2020 release will be implemented on June 1st. This is the first Washington WIC enhancement of Cascades. We purchased the system “as-is” and rolled out statewide in 2019. Since that time, we’ve collected input from state and local staff about potential changes and enhancements to make the system work better for Washington WIC.

We plan on having two enhancement releases each year, one in the spring and one in the fall. The System Enhancement Committee at the state office determines what goes into each release by reviewing all enhancement requests and evaluating them according to their impact in the following areas:

• Functional stability - keeping the system working reliably

• Performance efficiency - issues that affect system responsiveness and processing times

• Usability - efficiency and ease of use for state and local staff

• Federal requirements – assuring the system meets federal requirements

• Benefit issuance and participation - addressing issues to make sure participants receive full benefits and remove barriers to participation

• Security and reporting – includes system security, reporting, user accountability, and program integrity

• Urgency - how quickly the change is needed

• Budget and resources – the timing of an enhancement is also based on the time, money and effort required to make the change

What’s included in the Spring 2020 release

There are 5 enhancements for providing services to participants in this release.

1. Pregnant participants who transfer into state: staff can enter eligibility to the end of the month 6 weeks postpartum.

2. Child certifications extend to the end of the month the child turns 5 years of age. 3. A few remaining issues with releasing the Temporary Certification Ends Date were fixed. 4. Master Calendar memory issues that caused errors are also fixed. 5. 2019 and 2020 Nutrition Risk Factor updates from USDA/FNS are implemented

Please have staff review the topics that relate to their role in the clinic.

How to get the new version of Cascades

Log in to Cascades on or after Monday, June 1st to start using the new version.



Pregnant Participant Transfer Into State

When transferring a pregnant participant Into State, staff can now enter a Certification End Date that extends to the end of the month the participant turns 6 weeks postpartum (to the end of the month of the Expected Delivery Date + 6 weeks).

Example: Certification Start Date = 3/10/2020 Expected Delivery Date (EDD) = 8/24/2020 Certification End Date = 10/31/2020

[EDD + 6 weeks = 10/5/2020, then extended to the end of the month]

IDi f l690000::15~ 123 AIN ST. OL YM IA, WA 9s501

voe

VO Informa ion-------------------------t

Gertific.a'ian St..art Pate

1311012020 I D

Expoctoo Di!llrui"f Date

• 8/24/2020 [ ]

Certuit.Jl'iuri, E11d Di!te

I 10m12020 =::Ii

• Previously Cascades would only allow staff to enter a Certification End Date exactly 6 weeks from the Expected Delivery Date.

• This didn’t match Washington WIC policy for a pregnant participant’s eligibility period and federal regulations to accept a transfer participant’s full eligibility period from transfer information.


Detailed Participant Information

Participant Name: FIVEYEAROLD CHILD

Participant ID: WA1690006063 Family ID: F16900003557 category: Child

Certification Period: 4/24/2020 - 9/30/ 2020 Date of Birth: 9/ 2/ 2015

pr - va, a e May 2020 - Available Jun 2020 - Available

Clinic Name: Snohomish HD-Lynnwood


Child Certifications Extend to the End of the Month They Turn 5

When a child turns 5 years old during their certification, Cascades will use the last day of the month they turn 5 as the Certification End Date.

Any child already certified in Cascades who turns 5 on or after June 1st will have their Certification End Date extended to the end of the month they turn 5 years old.

Example: Child certified on 4/24/2020 Turns 5 years old on 9/2/2020 Certification End Date = 9/30/2020

Note:

Cascades doesn’t allow staff to schedule an appointment for a child on or after the 5th birthday. Staff can issue benefits, just not schedule an appointment for the child. This is on our list of potential changes for the future.

• Previously Cascades would set a child’s Certification End Date to the day before their 5th birthday. • This made some children receive one less month of food benefits depending on their birth date and

the Family Issuance Day.


Income Details

source

Zero Income Declaration Reason

! Nona,me

Proof

COmparison Frequency Annual

Frequency

Total Income $0.llO

Amount

Quick Links

Elgibay Guidelne Amount $39,461.00

8 New Family

• Family Search

hies

raphics

Income Information

Health Information

Anthro / Lab

Family Assessment

Dietary & Health

Eco-Social Assessment

Assigned Risk Factors

Certificat ion Signature

Certification Summary


Temporary Certification End Date Fixes

This release fixes a few scenarios where Cascades didn’t release the Temporary Certification End Date for missing proof when the proof was later provided.

Example 2: • Cascades didn’t release the Temporary Certification End Date for

participants who transferred from a household where proof ofresidency or income wasn’t provided to a household with proofentered.

• Cascades now uses the new household’s status of having proofprovided and releases the temporary end date.

Important note:

Staff need to save the Family Demographics and/or Income Information screen in the receiving family file for Cascades to update the transfer participant’s proofs and release the Temporary Certification End Date.

Example 1: • Staff documented “Not Provided” for proof of income at the certification. • At the next visit, staff determine the household has zero income and

document a Zero Income Declaration Reason. • Cascades now releases the temporary end date when staff delete the line

of income details where the proof was “not provided” and save the zeroincome reason on the Income Information screen.

6Washington State Department of Health WIC Program

Health Conditions

Nutrient Deficiency or Disease I

Fetal Alcohol Spectrum Disorder

' /'

0c= '-

•History

2/28/2020

Status Message

i Appointment(s) successfulty scheduled for CHILD's family.

2

"I

,)

r -

Date

I

\..

Risk Factors:

I Method I Risk Code I Description

I~ 131 LOW Weight Gain - BMI 18.5 - 24.9 s 132 W~ht Loss 2nd/3rd Trimester>- 2 lbs

"

~

I Created Date

2/28/2020 .2/28/2020


Clinic Master Calendar Memory Issue

Have you ever moved quickly from day to day while working with a participant to find the best time for their appointment, then had the Clinic Master Calendar freeze or give an exception error?

This Cascades release addresses the Clinic Master Calendar memory issue that caused these issues.

Risk Factor Changes

Every year USDA/FNS reviews and updates the federal nutrition risk criteria. The risk factor changes in this release are a combination of the 2019 and 2020 updates. Washington WIC received a waiver to delay some of the 2019 risk changes since we were implementing Cascades.

See the Table of Risk Factor Changes on the next page for an overview.

New risk titles are reflected in the Health Conditions mover box and on the Assigned Risk Factors screen

Any risks that were removed or renamed as a result of the risk updates will remain in Assigned Risk Factors History for all participants who had them previously assigned.

• We’ll post the Nutrition Risk Factor Tool with the risk definition changes on June 1st.

• We’ll let you know when we post the Nutrition Risk policy and procedure chapter. The chapter lists Definitions/Cut-off value, Justification, Implications for WIC Services, Clarification, and References for each risk from the federal risk criteria.


https://www.doh.wa.gov/Portals/1/Documents/Pubs/960-367-NutritionRiskFactorTool.xlsx

[ r


Table of Risk Factor Changes Risk Factor Risk Code Change Comments Low Weight Gain 131 • Definition/Cut-Off value didn’t change.

• Expanded the Justification section to include information about weight loss during pregnancy and updated with more current data on trends in maternal weight gain.

No change to Cascades.

Weight Loss During Pregnancy

132 Removed. The Low Weight Gain risk includes maternal weight loss.

Severe Nausea/Vomiting 301 • Updated the Definition/Cut-off value, but there’s no change in how or when staff determine the risk.

• Expanded and updated the Justification, Clarification and Reference sections.


Preeclampsia (Hx) 304 • Definition/Cut-Off value didn’t change. • Expanded and updated the Justification,

Clarification and Reference sections.


Breastfeeding While Pregnant

338 • Definition/Cut-Off value didn’t change. • Expanded and updated the Justification,

Clarification and Reference sections.


Nutrient Deficiency or Disease

341 • Changed name from Nutrient Deficiency Disease. • Risk definition revised to include “treated or

untreated nutrient deficiency or disease”. • Still requires a diagnosis by a health care provider.

Hypertension/ Prehypertension

345 • Definition/Cut-Off value includes terms used for hypertension: chronic hypertension during pregnancy, preeclampsia, eclampsia, chronic hypertension with superimposed preeclampsia and gestational hypertension.

• Expanded and updated the Justification, Clarification and Reference sections.



I r


Risk Factor Risk Code Change Comments Drug Nutrient Interactions 357 Risk definition change – added italicized words below:

Includes prescription or over-the-counter drugs or medications that interfere with nutrient intake, absorption, distribution, metabolism, or excretion, to an extent that nutritional status is compromised.


Alcohol Use Drug Use

372 Risk definition change: Now includes abuse of prescription medications.


Fetal Alcohol Spectrum Disorders

382 • Changed name from Fetal Alcohol Syndrome. • Now for all categories (not just infants/children). • Risk definition revised.

Regression 501 Risk definition change: The risk definition now aligns with federal regulations to only use this risk only one time following a certification where a nutrition risk was determined.

• No change to Cascades. • Washington WIC policy already

followed this requirement. • This risk is rarely used.

Transfer of Certification 502 Risk definition change: Clinic staff must accept transfer participants with a certification period that extends beyond the receiving agency’s certification period.

• Washington WIC uses the full eligibility periods for all participant categories.

• Staff can now enter eligibility to the end of the month a pregnant transfer participant is 6 weeks postpartum.

Maternal Substance Use (during pregnancy)

703 Removed • Use Limited Skills for Proper Nutrition or to Make Feeding Decisions when current use affects feeding ability.

• Use Fetal Alcohol Spectrum Disorders or Neonatal Abstinence Syndrome, or other risks when applicable.

Limited Skills for Proper Nutrition or to Make Feeding Decisions

902 Risk definition change: This risk now includes intellectual disability, substance use, and misuse of prescription medications.

• Cascades assigns this risk when staff document Limited Abilities to Feed, or Maternal Intellectual Disability on the Eco-Social screen.

• Staff can manually select this risk on the Assigned Risk Factors screen.
