attachment-41-rfb-2027-dph-01-formu-cherokee-return.pdf

CHEROKEE NATION WIC NUTRITION PROGRAM

Policy Number: FBD3040

Effective Date: 05.15.2019

FBD3040 | Managing Returned Formula Page 1 of 3

3 | Food Benefit Delivery

Managing Returned Formula

Policy Cherokee Nation WIC clinics will accept returned formula purchased with a WIC card for the purpose of making an equivalent exchange based on the formula’s reconstituted amount.

Participants cannot receive more than the maximum amount of formula allowed by Federal regulations for the month.

Returned formula CANNOT be reissued and MUST be destroyed.

Purpose To establish procedures for exchanging and managing returned formula.

Reference 7 CFR Part 246.4(a)(14)(xviii); USDA FNS WIC Food Package Policy and Guidance (March 2018)

WIC Mosaic Training Notebook/Knowledge Base Articles

Definitions Returned Formula is formula originally purchase by WIC that is returned to the clinic by the participant and/or parent/guardian/caregiver of a participant.

Procedures

1. Management of Returned Formula

a. Document the receipt of the returned formula on the Returned Formula Log by noting:

i. Formula Return Date

ii. Participant Name

iii. Participant Date of Birth

iv. Formula Name

v. Formula Type (Powdered, Concentrate, Ready to Use)

vi. Quantity Returned

vii. Staff Name

viii. Transferred Date

FBD3040 | Managing Returned Formula Page 2 of 3

ix. Date Destroyed

x. Destroyed By (Staff Name)

b. All returned formula will be transferred to the Main Office for destruction.

c. Returned Formula Logs are to be maintained in the WIC Clinic until formula is transferred to the Main Office for destruction. At that time, staff will print or send via email the Returned Formula Logs with the formula being shipped to the Main Office for destruction.

d. Returned formula must be kept out of sight of participants.

e. The Returned Formula Logs will be monitored by the WIC Clinic Supervisors, Nutrition Education Coordinator and/or WIC Office Manager.

f. Completed Returned Formula Logs will be maintained at the Main Office.

2. Formula Exchanges when All or Some of the Formula is Remaining on the WIC Card

a. Formula will be exchanged based on the equivalent quantity of reconstituted formula being returned and formula being issued onto the WIC Card.

b. When there is formula remaining on the Cherokee Nation WIC Card, staff are to update the participant’s WIC card with the new formula and remove the previous formula from the WIC card.

Example One: Sally’s daughter Allie (Infant-Formula-Age 0-3) was issued 9 cans of Similac Advance powder on her WIC card. She purchased 2 cans of Similac Advance powder leaving 7 cans of Similac Advance powder remaining on her WIC card. She used one can. Today she has a doctor’s statement for Similac Alimentum powder.

(Note: the full quantity for Similac Alimentum for an Infant-Formula-Age 0-3 is 10 cans.) You will issue 8 cans of Similac Alimentum powder to her WIC card because that provides the equivalent quantity of reconstituted formula. She brought the one unopened can with her so you will also give her one can of Similac Alimentum from your stock of purchased infant formula. Record the 1 can of formula mom returned on your Returned Infant Formula Log.

Example Two: Grace has been receiving an Infant-SBF-0-3 food package containing Similac Sensitive powder and was issued 9 cans on her WIC card. Today, mom comes in with a doctor’s statement needing Pregestimil powder. (Note: the full quantity of Pregestimil powder for an Infant-SBF-0-3 is 8 cans) Mom purchased 5 cans of Similac Sensitive powder leaving 4 cans remaining on the WIC card. You will issue 3 cans of Pregestimil to the WIC card because that provides the equivalent quantity of reconstituted formula. Mom has 4 cans of Similac Sensitive powder with her. You will exchange 4 cans of Pregestimil from your purchased formula stock and record the 4 cans of Similac Sensitive on your Returned Formula Log.

FBD3040 | Managing Returned Formula Page 3 of 3

c. WIC Clinic staff may have to order formula to complete the exchange, if the formula isn’t already in the clinic’s inventory.

d. Formula being returned with or without an equivalent exchange must be documented in the Notes Section on the Family Page.

e. Formula purchased prior to the current month cannot be exchanged; however, WIC staff can accept the return of the formula. It is to be added to the Returned Formula Log and sent to the Main Office for destruction.

3. Formula Exchanges when All Formula has been Removed from Card

a. Formula will be exchanged based on the equivalent quantity of reconstituted formula being returned and formula being issued onto the WIC Card.

b. All returned formula will be logged on the Returned Formula Log.

c. WIC Clinic staff may have to order formula to complete the exchange, if the formula isn’t already in the clinic’s inventory.

4. Disposal of Returned Formula

a. Concentrated and ready-to-use formula containers are to be opened and its contents poured down the drain.

b. Powdered formula containers are to be opened and its contents poured into a trash bag.

c. Note destruction of the formula on the Returned Formula Log.

d. All formula returned to the Main Office will be disposed of within three business days.

Policy Review History

• 5/16/2019 by pwedding