| Funding
Timeframe |
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What is the timeframe
for using this money? |
| |
The FY 2008 peer counseling funds
can be used through September 2009.
(The FY 2007 peer counseling funds can be used through September
2008)
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| Requirements
for Receiving the Funds |
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What are the requirements for
receiving the FY 2008 funds?
|
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As in previous years, State agencies
will be required to continue to implement/administer a peer
counseling program based on the Loving Support™
Model for a Successful Peer Counseling Program (Loving Support™
Model) and consistent with program guidance set forth in the
Using Loving Support to Manage Peer Counseling Programs and
Loving Support through Peer Counseling training curricula.
State agencies accepting breastfeeding peer counseling funds
for the first time must use these funds to arrange for designated
staff to receive both trainings: Using Loving Support
to Manage Peer Counseling Programs™ is designed
for State WIC Directors and State Breastfeeding Coordinators
and/or Nutrition Coordinators; Loving Support through Peer
Counseling is designed for State and local staff who train
peer counselors.
As with all WIC appropriated monies, accountability is a
requirement for receiving funds. Because these funds were
appropriated by Congress to expand WIC breastfeeding support
services through peer counseling as a strategy to increase
breastfeeding rates, it is necessary to demonstrate that State
agencies accepting the funds have, or plan to have, a breastfeeding
peer counseling program that includes all components of the
Loving Support™ Model. State agencies accepting
peer counseling funds must submit an implementation plan and
annual progress reports. |
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Do we have to submit an implementation
plan at the beginning of each new two-year grant period? |
| |
State agencies accepting peer counseling
funds for the first time are required to submit an implementation
plan demonstrating that they intend to implement all of the
components of the Loving Support ™ Model.
Implementation plans, including a line item budget, are to be
submitted as an addendum to the State Plan. State agencies receiving
breastfeeding peer counseling funding in subsequent grant periods
are not required to submit a new implementation plan, but must
agree to continue to build upon and expand activities outlined
in their original implementation plans, and fulfill reporting
requirements. |
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What are the reporting requirements?
|
| |
For each two-year grant period, all
State agencies receiving peer counseling funds are required
to submit an annual and final Financial Status Report (SF-269)
and annual progress reports. Annual progress reports describing
the peer counseling program can be submitted via the State Plan.
Beginning with FY 2006, State Plan guidance includes a format
for reporting this information. Annual progress reports must
demonstrate that State agencies are continuing to build upon
and expand the activities outlined in their approved implementation
plans. A line item budget demonstrating how the funds will be
used for these activities must also be included. State agencies
are also required to provide FNS their status of outlays and
obligations against the grant during the second fiscal year
of each two-year grant period so that unused funds can be
recovered and made available to other State agencies before
the funds are no longer available for this purpose. |
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Do all of the components of
the Loving Support™ Model need to be
in place in our program before we can access any of these funds? |
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State agencies accepting peer counseling
funds for the first time must demonstrate that they have plans
to implement all of the components. To receive the funds, implementation
plans have to address all components of the Loving Support™
Model, and demonstrate how the State agency will implement a
new program in a pilot area, or enhance/expand an existing peer
counseling program.
To receive the funds in subsequent grant periods, State agencies
must demonstrate that they are building on the activities
outlined in their implementation plans, with a goal to continue
to expand a comprehensive peer counseling program that will
include all components of the Loving Support™
Model.
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| Future
Funding |
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If we implement a peer counseling
program, how can we be assured that funding will continue in
subsequent years? |
| |
The Child Nutrition and WIC Reauthorization
Act of 2004 earmarks $20 million per year for special nutrition
education such as breastfeeding peer counseling and related
activities. However, this amount can be increased or decreased
on an annual basis through the appropriations process. To ensure
that funds will continue to be made available, FNS must be able
to demonstrate that State agencies are using the funds in accordance
with FNS' research-based model for a successful peer
counseling program. Absent these earmarked funds, a State agency’s
NSA funds can always be used to support a peer counseling program. |
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How will FNS demonstrate that
State agencies are using the funds in accordance with FNS'
research-based model for a successful peer counseling program? |
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Primarily through review of State agency
implementation plans, State Plan annual progress reports, and
management evaluations. FNS is also planning to systematically
document the breastfeeding peer counseling implementation process
nationwide beginning in FY 2007. Data collection and analysis
will be conducted by an outside contractor. Results of this
review will be used to: (1) capture and disseminate information
on implementing peer counseling programs using the Loving
Support™Model, including lessons learned
and successful approaches used by State agencies; (2) assess
the additional technical assistance and training needs of State
agencies; and (3) provide a report to Congress demonstrating
how State agencies are using the peer counseling funding. |
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One of the components of the
Loving Support™ Model is: ‘Establishment
of standardized breastfeeding peer counseling program policies
and procedures at the State and local level as part of the State
agency’s nutrition education plan.’ We are hesitant
to take the necessary steps to institutionalize peer counseling
activities in this manner because of the possibility of losing
these funds in the future. |
| |
Regardless of future special funding
for peer counseling, State agencies are strongly encouraged
to take steps to ensure that peer counseling becomes a standard
service in WIC as a method to further increase breastfeeding
rates. In this current climate of budget tightening for all
WIC funding, State agencies are advised to conduct a critical
assessment of status quo breastfeeding and promotion activities
throughout the State and ensure that program funds are being
spent on activities that are research-based. At the State agency
level, such an assessment can be used to inform funding and
management decisions aimed at making breastfeeding promotion
and support in local agencies more effective. Many State and
local agencies were operating successful peer counseling programs
before the special funds were made available, and many were
able to do so through judicious use of program funds.
The use of peer counselors, combined with management and
support components to sustain peer counseling programs, adds
a critical dimension to a State agency’s efforts to
help women initiate and continue breastfeeding, especially
in the critical weeks after birth and beyond. FNS hopes that
State agencies will continue to embrace the importance of
peer counselors as part of their overall breastfeeding and
support activities.
|
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| Definition
of Peer Counselor |
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What is the definition of ‘paraprofessional’
in FNS’ definition of breastfeeding peer counselor? |
| |
For the purposes of using these funds,
peer counselors fall under the general category of paraprofessionals
– those without extended professional training who are
selected from the group to be served and are trained and given
ongoing supervision to provide a basic service or function.
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We use dietetic interns and
call them peer counselors. They do not meet the definition of
peer counselor as outlined in the Loving Support Model. May we continue
to use them? |
| |
You may continue to use them but you
may not fund them using the breastfeeding peer counseling funds
because they do not meet the definition of peer counselor as
outlined in the Loving Support™ Model.
|
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May we use these funds to pay
for the salaries of our dual-role staff when they are performing
peer counseling duties? (These staff perform clerical duties
part-time and peer counseling duties part-time to equal a full-time
job.) |
| |
The peer counseling funds may be used
for these dual-role staff only if these staff meet the definition
of peer counselor as outlined in the Loving Support™Model.
These special funds are intended to take programs beyond current
operations and improve services offered to WIC participants,
e.g., making peer counseling services available to WIC clients
outside usual clinic hours and outside the WIC clinic environment.
When determining how you may want to use these special funds,
think not in terms of how your program is currently being operated,
but how this money can be used to fill the gaps in peer counseling
services offered to WIC participants. |
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We use male peer counselors.
May these funds be used to pay for their salaries? |
| |
No. The definition of peer counselor
in the Loving Support™ Model is based on research
demonstrating the benefit of hiring peer counselors from the
target population. WIC’s target population is WIC-eligible
women. This does not mean that male peer counselors are not
valuable members of breastfeeding promotion and support programs.
However, breastfeeding promotion and support programs that include
components and activities that are outside of those defined
by the Loving Support™ Model must be
funded through the regular NSA grant (if an allowable cost)
or other sources. |
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How do we help regular
WIC staff understand the role of the WIC peer counselor? How
do we keep regular WIC staff from being resentful of peer counselors? |
| |
As discussed in the training
curriculum, helping regular WIC staff “buy in” to
the concept of peer counselors may help alleviate feelings of
resentment. The CD-ROM included in the Using Loving Support
to Manage Peer Counseling™ Programs training
manual provided to all State agencies includes a one-hour Power
Point presentation Peer Counseling: Making a Difference for
WIC Families. This presentation can be used to help orient local
WIC clinic staff about the peer counseling program, solicit
their support for the program, and help them view peer counselors
as unique partners who complement and reinforce their work with
WIC participants.
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| Training
Curriculum |
|
Is it mandatory that we use
the ‘Loving Support through Peer Counseling™
curriculum’ to train breastfeeding peer counselors? May
we use another peer counseling curriculum? |
| |
State agencies that accept breastfeeding
peer counseling funds may use any peer counseling training
curriculum they wish as long as they ensure that the training
curriculum includes the research-based components of a successful
peer counseling program as presented in both Using Loving
Support to Manage Peer Counseling Programs™
and Loving Support Through Peer Counseling™.
We are aware that there are other excellent training curricula
currently available to WIC State agencies—in fact, in
addition to a review of the literature, much of the research
base for development of the Loving Support™
peer counseling curricula comes from those existing curricula/programs.
WIC State agencies should assess any peer counseling training
curricula they intend to use to train peer counselors against
the Loving Support™ curricula and enhance or
modify their training programs, if needed, to include the
research-based components presented in the Loving Support™
training. Peer counselors that have been trained with other
curricula can be updated on these components, as necessary,
as part of their ongoing continuing education.
FNS’ goal is to ensure that all WIC State agencies
that are using the special peer counseling funds appropriated
by Congress operate their peer counseling programs from the
same basic foundation – an evidence-based research model
that is appropriate for the WIC-clinic environment. Program
effectiveness related to the continued provision of these
funds can best be assessed if all peer counseling programs
using these funds operate from that same basic foundation.
State agencies have the flexibility to use any other peer
counseling training curricula as long as the basic foundation
and research principles described in the Loving Support™
curricula are included.
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| State
Agencies with Existing Peer Counseling Programs |
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Do State and/or local WIC agencies
that currently have peer counseling programs have to terminate
those programs if they don’t meet the components of the
Loving Support™ Model? |
| |
No. State and/or local agencies may
continue to operate existing peer counseling programs with their
Nutrition Services and Administration (NSA) grants or other
funding sources. However, if the breastfeeding peer counseling
funds are used to pay for any portion of an existing peer counseling
program, the peer counseling program must be enhanced to include
all of the components of the Loving Support™
Model. |
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May these funds be used to supplant
our current peer counseling activities so that our NSA grants
can be used for other purposes? |
| |
No. If a peer counseling program is
currently in place, use of these funds is limited to enhancing
those programs to meet the components of the Loving Support™
Model. If a program meets all the required components, the funds
may be used to expand the program to other locations in the
State. |
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Can you provide some examples
of how these funds can be used to expand activities in a State
or local agency that already has a peer counseling program? |
| |
We recommend that State agencies assess
their current peer counseling programs against the Loving
Support™ Model. Look at the gaps in peer counseling
services provided to participants, and look to see where holes
may exist in programs in the area of support and management
of peer counselors. Use the funds to provide services and activities
to close the gaps. Any remaining funds can be used to expand
services, e.g., by hiring additional peer counselors and/or
expanding the program to a new county or local agency. |
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May we use the funds to pay
our existing peer counselors if we plan to make enhancements
to the program? |
| |
Because these funds are to be used to
enhance what State agencies are already doing, the funds may
be used to increase the pay of existing peer counselors, in
addition to making enhancements to the program.
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| Allowable
Costs |
| General
Note: Allowable cost determinations for a particular
State agency will be made within the context of reviewing the
State’s implementation plan to ensure that all components
of the Loving Support™ Model for a successful
peer counseling program are included and that an appropriate
balance between direct service delivery by peer counselors and
the purchase and use of equipment and materials is in evidence. |
|
Is childcare an allowable cost
under the peer counseling funds? |
| |
No, childcare is not an allowable WIC
cost. |
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May the peer counseling funds
be used to train peer counselors to become International Board
Certified Lactation Consultants (IBCLC’s)? |
| |
The research recommends that peer counselors
be provided career path options (e.g., training/experience to
become senior level peer counselors; advanced training to become
lactation consultants, etc.); therefore, the funds may be used
for this purpose. However, the priority use of these funds is
to hire and train peer counselors to provide breastfeeding peer
counseling services to WIC participants. We would not expect
to see an implementation plan heavily focused on training IBCLCs. |
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May the peer counseling funds
to be used to enhance our IBCLC infrastructure? |
| |
One of the components of the Loving
Support™ Model is the provision of adequate program
support of peer counselors through timely access to breastfeeding
coordinators and other lactation management experts for assistance
with problems outside the scope of practice of the peer counselor.
Therefore, funds may be used to strengthen the availability
of lactation management experts available to peer counselors.
However, the funds may not be used to disproportionately hire
and train lactation management experts versus peer counselors.
The priority use of these funds is to hire and train peer counselors
to provide breastfeeding peer counseling services to WIC participants.
We would not expect to see an implementation plan heavily focused
on hiring IBCLCs. |
|
May we purchase breastfeeding
incentive items with these funds for the purpose of encouraging
our mothers to breastfeed? May funds be used to develop hospital
discharge bags to give to mothers in the hospital? |
| |
No. The intent of the funds is to enhance
WIC breastfeeding support services to program participants through
peer counseling, not to pay for incentive items and other materials
for participants. Regular NSA or other funds should be used
for this purpose. The peer counselor may, however, provide incentive
items to participants in the course of her peer counseling contacts
with them. |
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Would it be an allowable cost
to produce a handout on the peer counseling program to publicize
the efforts? |
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The funds may be used to produce and
distribute a handout to educate WIC participants about the peer
counseling program. However, educational materials to promote
breastfeeding are to be paid out of regular NSA funds. |
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May program indirect costs be
included as allowable expenses? |
| |
Yes. |
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May we purchase shirts that
identify the staff as peer counselors with this money? |
| |
Yes; however, these funds are primarily
to be used to provide breastfeeding support services through
peer counseling to WIC participants, not simply to purchase
items and materials. |
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May the funds be used to install
a phone line or purchase answering machines and pagers for peer
counselors? |
| |
Yes. |
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May we buy breastfeeding resources
for the peer counselor coordinator/supervisor with this money?
May we buy resources for other WIC clinic staff? |
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Breastfeeding resources for the peer
counselor coordinator/supervisor may be purchased with this
funding only if the resources are related to peer counseling,
e.g., training manuals for peer counselors. Otherwise, breastfeeding
resources for peer counselor supervisors and other WIC staff
should be paid for through regular NSA funds. |
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May our nutrition coordinator
perform the duties of a peer counselor manager/coordinator if
we then hire someone else to perform the nutrition coordinator
duties with other WIC funds? |
| |
Yes. This would be a proper use of the
funds because the State agency is designating a peer counselor
manager/coordinator where there was not one previously. |
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May our paraprofessional nutrition
educator, who meets the definition of peer counselor as outlined
in the Loving Support™ Model, perform the duties
of a peer counselor with this money if we then hire someone
else to do her nutrition educator job duties with other WIC
funds? |
| |
Yes. If she meets the definition of
peer counselor in the Loving Support™ Model and
receives the appropriate training, the funds may be used to
pay her salary. |
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May funds be used to hire a
peer counselor to staff a breastfeeding hotline? May the funds
be used to pay for expenses related to the hotline? |
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Funds may be used to hire a peer counselor
to answer calls to a hotline or call center if the peer counselor
meets the definition of peer counselor and receives the appropriate
training and supervision as outlined in the Loving Support™
Model. Expenses related to the hotline/call center are allowable
for any portion of those expenses that are for the purpose of
a peer counselor providing participant contacts. |
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May the funds be used to purchase
portable cribs for peer counselors who bring their babies to
work? |
| |
No. The peer counseling funds may not
be used to purchase equipment/materials for the infants of peer
counselors. |
|
May we purchase furniture and
computers for peer counselors? |
| |
The primary purpose of the funds is
to provide breastfeeding support services through peer counseling
to WIC participants. The funds may be used to purchase office
equipment and furniture if these items are necessary to provide
these services.
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| Miscellaneous |
|
May peer counseling
contacts with pregnant and/or postpartum women count as second
nutrition education contacts? |
| |
The peer counseling funds
are to be used for activities that are in addition to current
required WIC activities. Regular WIC program funds (NSA) provide
for at least two nutrition education contacts; therefore peer
counselor grant funds are not to be used for the “second”
contact. |
|
Are State agencies
required to include peer counseling in their Management Evaluations
of local agencies? |
| |
Yes. Peer counseling falls
under the State agency’s regular review of nutrition services.
|
|
May WIC peer counselors
provide services to non-WIC participants? |
| |
WIC peer counselors may
not provide breastfeeding peer counseling services to non-WIC
participants. Peer counselors should refer WIC-eligible women
to the WIC clinic to apply for WIC benefits. Peer counselors
should refer women who are not WIC-eligible to appropriate non-WIC
resources. |
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May we use these
funds to conduct an evaluation of the effectiveness of our peer
counseling program? |
| |
No. The peer counseling
funds are not to be used for evaluation.
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