Havre Daily News
Local providers of a government nutrition program for low-income women and children have a few months to meet new federal requirements before possibly facing closure.
New federal rules for the Montana Special Supplemental Nutrition Program for Women, Infants and Children, commonly known as WIC, give local contractors until Oct. 1 to have a registered dietician on staff - something local offices are finding difficult to do.
"We are doing everything we can to meet the requirements, but if there's anyone out there, come out of the woodwork because (registered dieticians) don't grow on trees," said Kari Dawson, director of the Havre WIC office. "Especially not in Montana."
WIC provides nutrition counseling and food vouchers for expecting and nursing mothers and for infants and children who meet certain household income and risk factor criteria.
"WIC is pretty much eating healthy," said Ristina Wilting, 24. She said the service eased many aspects of her two pregnancies and helps her care for her toddler, Sydney, 22 months, and new infant, Mason, 2 weeks.
The WIC office in Havre serves 426 women in Hill, Blaine and Liberty counties. Dawson travels to Chinook and Chester once a week to meet with women and children there.
The WIC offices in Havre and on the Rocky Boy's and Fort Belknap Indian reservations are among 13 contractors of 29 statewide that have yet to say they can comply with the state's new requirement, Montana WIC director Chris Fogelman said Tuesday.
For the last two years the state has asked WIC clinics to provide a part-time dietician to counsel high-risk clients. That was the grace period, Fogelman said. "They have had warning," she added.
If Oct. 1 comes around and offices still don't have a dietician, a letter will go out and the contract might be cancelled, she said.
The state has closed an office that could not provide qualified staff in the past. If that happens, Fogelman said, the state will look for another contractor in the area to fulfill the requirements. If no one can do it, local WIC recipients might be asked to travel to another WIC office.
The Montana WIC program will send out a call for budgets in mid-July and Fogelman said she may yet hear that more contractors have found dieticians when they submit their budgets.
"I think I've been one of the few places that was ahead of the game," Dawson said. For the past year she had a part-time dietician who traveled from Great Falls for appointments, but that woman's contract ends this month and she will be moving.
Dawson said she is hopeful she will find another part-time dietician in time and is considering getting a degree as a registered dietician herself. She has degrees in nursing and chemistry and is also working toward certification as a lactation consultant.
In addition to the requirement that offices provide a dietician, new education requirements will go into effect the same day, Fogelman said. New staffers will need 12 nutrition credits, up from a requirement of three instituted last year.
Dawson said finding qualified staff in the future may be difficult.
"We're asking quite a lot in Havre, Montana," Dawson said.
So far, Dawson said she's been lucky.
"I have a nurse that is being paid less than the professional average who was willing to take online courses" to meet the three-credit requirement, Dawson said. That nurse is part time.
Most Montana schools do not offer many nutrition credits and there's a shortage of dieticians in the area, she said.
Lois Gopher, director at the Rocky Boy WIC clinic, said she had not heard about the new requirement for a dietician. She did know about the education requirements. Gopher said she refers some clients to a dietician at the Rocky Boy Health Clinic and might look to that woman for a contract to meet the new requirement. The Rocky Boy WIC program has 360 participants.
The Fort Belknap WIC program, with offices in Fort Belknap and Hays, does not have a dietician, director Arlene Cochran said. Cochran said she is not sure how that requirement will be addressed since the tribe, not Cochran, is supposed to fulfill the contract. The Fort Belknap WIC program serves about 350 people, she said.
Fogelman agreed that finding staff in rural parts of the state might be hard. Her office receives calls from qualified job applicants looking for placements, she said, but most want to live in western Montana.
"People aren't necessarily thinking of the rural areas," Fogelman said.
The requirements will improve the quality of the service clinics can offer, she said, and the rural offices can find ways to fulfill them.
When the state began to require that staffers have three nutrion credits last year, it found a school that could offer those credits online, Fogelman said. It will do the same for the 12-credit requirement.
"Do I think it will be harder in some places in the state?" said Kim Mondy, public health nutirionist for Montana WIC. "Yes, it probably will be."
Directors have to be creative, Mondy said. In Plentywood, a local WIC office looked to North Dakota to find a dietician who could travel to town for appointments, she said.
Maybe there's a stay-at-home mother with a degree out there, Dawson said.
Dawson's message to people who think they may be eligible for WIC help: Apply to join and take advantage of the service that is available in Hill, Blaine and Liberty counties and on local reservations.
Local WIC participant Ristina Wilting said WIC has taught her better breastfeeding technique, and has kept her house stocked with milk, cheese and cereals that would have been difficult to afford without the program.
"You'd have to find a way, but it really helps," Wilting said. "I wouldn't buy as much milk as they give."
Certain things WIC has taught her were not obvious.
Wilting was surprised when Dawson told her to add butter to her daughter's vegetables. Sydney, who was underweight, now loves butter, she said.
As far as Dawson is concerned, that's a good thing. "We're all educated in low fat," Dawson said. That does not apply to infants and toddlers.
The WIC program is open to pregnant women or recent mothers and infants who fit income requirements and one of 60 indicators of poor nutrition.
For a family of two, which Dawson said can be a pregnant mother, an annual income of under $23,736, along with risk factors, qualifies the mother and child. In a family of five, the income requirement is $41,829.
The amount of food prescribed through the program is based on a person's nutritional needs, not income, Dawson said.
Dawson's office is responsible for giving out food vouchers that account for $29,000 a month in food sales in Hill County alone, she said. In Blaine and Hill counties, her office provides vouchers that account for another $6,000 to $10,000 a month in food sales.
Babies enrolled in the program can stay in it until age 5, Dawson said. Women who have given birth stay in WIC until either six months or a year afterward - a year if they breastfeed and six months if they don't.