Women, Infants and Children Overseas WICO

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Women, Infants and ChildrenOverseas (WICO)
Department of DefenseRevised February 2001
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Women, Infants ChildrenOverseas (WICO)

• WIC is a supplemental food and nutritional
  education program authorized in 1972 by the Child
  Nutrition Act
• Provides eligible participants with
• supplemental nutritious food
• nutrition counseling and education
• nutrition-health screening
• referrals to other health agencies

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Who is Eligible?

• Pregnant or postpartum women, infants (up to 1st
  birthday), and children up to age 5
• Breastfeeding women (up to infants 1st birthday)
• Non-breastfeeding postpartum women
• (up to 6 months after the birth of an infant or
  after pregnancy ends)

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Who is Eligible? continued

• Women and children determined to be at
  nutritional risk
• Medically-based risks (designated as high
  priority) such as anemia, underweight, maternal
  age, history of pregnancy complications, or poor
  pregnancy outcomes
• Diet-based risks, such as inadequate dietary
  pattern
• Families whose gross income falls at or below
  185 of the U.S. Poverty Income Guidelines

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Why WIC Overseas?

• Equity
• Extends domestic benefit overseas
• A Population Health Issue
• Nutrition counseling and education
• Other health concerns identified e.g. mothers
  smoking, use of alcohol, etc.
• Congressionally mandated in 2000

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Did You Know?

• One in four new mothers participate in WIC
• WIC serves 45 of all infants born in the U.S.
• Eligible stateside participants can use WIC,
  which is a Department of Agriculture program
  operated locally by state and county health
  departments

Source United States Department of Agriculture
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Did You Know? continued

• WIC participation is associated with reductions
  in the prevalence of very low birthweight babies.
• WIC participation during pregnancy is associated
  with significantly lower incidence of infant
  mortality.
• WIC children have improved dietary intake,
  reduced rates of iron deficiency anemia, improved
  cognitive development, and improved immunization
  rates.

Source United States Department of Agriculture
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DoD WICO

• WICO is a health benefit -- not a TRICARE
  medical benefit
• WICO is managed by TRICARE, but funded by
  external DoD funds -- Under Secretary of Defense
  (Personnel Readiness)
• Estimated Mature Costs 16 million/year

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Implementing WIC Overseas

• WIC Overseas has been designated as a TRICARE
  Program Management (PM) program
• Integrated Program Team (IPT) formed to develop a
  plan and to coordinate implementation of WIC
  Overseas
• Three Working-level Integrated Program Teams
  (WIPTs) formed to address clinical, eligibility,
  and financial aspects of project

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Implementing WIC Overseas continued

• Integrated Program Team (IPT) membership
• includes representatives from
• TRICARE Management Activity
• USD (Comptroller)
• Service Assistant Secretaries (MRA)
• ASD (FMP)
• Service Surgeons General (plus USMC)
• TRICARE Europe/Pacific/Latin America
• Defense Commissary Agency (DeCA)
• Navy Exchange Command
• Defense Finance and Accounting Service (DFAS)
• Department of Agriculture

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Implementing WIC OverseasConcept of Operations

• Concept of Operations Turn-key GOCO (Government
  Owned, Contractor Operated)
• Problem Knowledge Couplers, Inc. (PKC)/ Burger,
  Carroll, and Associates (BCA)
• Development, testing, and implementation of WIC
  Eligibility Coupler
• Preparation of Central Operations and Service
  Site manuals.
• Preparation of training materials for service
  site implementation of policies and procedures.
• Development of food instrument (WIC draft).

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Implementing WIC Overseas Concept of Operations
continued

• Concept of Operations Turn-key GOCO (Government
  Owned, Contractor Operated)
• Choctaw Management/Services Enterprise (CM/SE)
• Acquisition, installation, and maintenance of
  hardware and office equipment.
• Identification, hiring, and training of WICO
  personnel.
• Establishment of banking operation.

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WIC Overseas

• WICO offices to be established
• Enrollment
• Medical screening
• Nutrition counseling and education
• WICO draft distribution
• Estimated population 30,000-40,000
• Includes DoD federal employees
• DoD contract employees
• Focus Groups
• Identify participant concerns and determine best
  implementation, marketing and education practices

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Overseas FacilitiesEligible to Participate in
WIC Overseas

• 65 Medical Treatment Facilities (MTFs)
• Europe 52 (including Iceland)
• Pacific/Far East 12
• Latin America 1 (Guantanamo Bay, Cuba)
• 92 Commissaries
• Europe 64 (including Iceland)
• Pacific/Far East 28
• 12 Navy Exchange Markets (NEXMARTS)
• Europe 10
• Pacific/Far East 1
• Latin America 1 (Guantanamo Bay, Cuba)

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Phased Implementation

• Phase I -- Early 2001
• Yokosuka, Japan
• Okinawa, Japan
• Guantanamo Bay, Cuba
• Lakenheath, England
• Baumholder, Germany
• Phase II -- Mid-year 2001
• All remaining sites served by Medical Treatment
  Facilities, Commissaries, and NEXMARTS

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Challenges

• Food Instruments (WICO drafts) not redeemable in
  public stores overseas
• Only in Commissaries and NEXMARTS
• Remote Area Implementation
• Medical screening facility and food source
  required