Leaving my desk in the middle of a participant visit to arrange to have a food package changed.  Especially if it is to change to another contract formula or milk/cheese ratio.  (not a CPA)

Having to enter new food packages when the contract formula changes or the standard food packages change.  The State should be able to do this en masse from their level.  They should have made the changes by altering the content of the food package.

Remembering to do all of the “little things” that need to be done, like voter registration, time studies and computer problems.

M-SPIRIT has an improved user interface that prompts for missing required certification items. M-SPIRIT has a required field in demographics called “Register to Vote” where you enter “Yes”, “No” or “Already Registered”. The user will not need to remember, since it is a required field.

No one specific task, but a gradual accumulation of small tasks.  Each minute that we add to an appointment adds up to a large amount of allotted time in the course of a year.  For example, a successful SIS check (assuming that the system doesn’t fail and that the name on the Medicaid card is the same as the one in the system) takes about 1 to 1 ½ minutes. If a WIC worker sees 12 participants per day, that’s an average of 15 minutes per day. 49 weeks per year x 5 days per week = 245 days x 15 minutes = 3675 minutes per year = 61.25 hours per year. In other words, a full time worker is now spending more than a week and a half per year checking SIS. Is it really worth it? Is it federally required? Most MT WIC participants do not lie about Medicaid eligibility. There are occasional participant errors: they are often unaware of their current status or have missed a deadline. However, WIC staff members are spending a huge amount of time checking accountability when we could be engaging with participants. (2 comments)

All the additional documentation such as breast pump logs, computer logs, initialing BODs and EODs, and more.

There will be no BOD/EOD with M-SPIRIT. M-SPIRIT will be used to manage Breastfeeding items like pumps. M-SPIRIT will be paperless.

Transfer process within Montana and especially between our own satellite clinics:  the request for transfer and uploads and downloads, trying to keep track of the transferring ID numbers and participants, bet them scheduled with transfers-pending.  It is too easy to make errors.

M-SPIRIT has a vastly improved transfer process. Transfers will be instantaneous with M-SPIRIT. There will be no “Pending” transfers to keep track of.

Telephone calls, messages, re-scheduling, re-scheduling, re-scheduling…..

The M-SPIRIT scheduling functionality is easy to use and should make scheduling and rescheduling easier than the current system. Also, M-SPIRIT reports can list out participants with upcoming or missed appointments to make the scheduling task easier.

Participant services including phone calls, checks, appointments, and rescheduling missed appointments.

Contacting participants, either by phone or mail to remind them of their upcoming appointment, then to let them know they missed, etc.

M-SPIRIT will retrieve all participants who missed appointments within a date range and allow a person to easily follow-up with each participant. M-SPIRIT can print “Missed Appointment” Notices for all participants who missed appointments within a date range. M-SPIRIT does have the capability to print out upcoming appointment notices.

With the stress of trying to keep our numbers up so that we don’t have our budget cut any further, I do not follow up on all no show participants.  Which includes phone call and letters.

Participants who are late for their appointment.

Certification and recertification no shows, the 30-45 minutes that we now have no one to serve and then the next appointment time that will be needed to certify the participant.

Participants who do not have their paperwork filled out.

Participants who interrupt the appointment to take a cell call, take a child to the bathroom, change a baby’s diaper.

Participants with so much stuff or not very organized to move efficiently from waiting room, to weight area, to staff office.

Difficulty in participant comprehension on specifically what they need to bring to complete the cert appointment.  State and local agencies don’t always communicate well on what is considered appropriate, for example, as proof of residency and income.

Having participants come back in one month rather than in two or three months because they didn’t bring “acceptable” proof of residency, even if they haven’t moved, even if they brought non-acceptable proof.  This adds more appointments in the certification period.

Verifying address continually, signing and tracking WIC form and making sure address get verified with the limited options, copying it.  Are we more limiting in what we can accept and making this more time consuming for us and frustrating for the participant.  Why can’t OPA information be used, or information on paystubs, bank accounts as it appears other states have allowed these?

The number of signatures for both the participant and certifier during Cert/Subcert appointments, including the notification of end certification and certification appointment notice forms.

Fewer signatures will be required with M-SPIRIT.

Multiple signatures required from staff and participant on several different forms for close to the same thing or forms that could be combined into one.

Fewer signatures will be required with M-SPIRIT.

Signing and dating on WIC forms multiple times.

Fewer signatures will be required with M-SPIRIT.

Checking Medicaid eligibility in SIS.

Having to complete paperwork for void/reissues when the data is now entered in the computer with how many cans are returned and how many are reissued.

M-SPIRIT is a paperless system.

Required multiple paper forms for special formulas.

M-SPIRIT is a paperless system.

Special formula requests.

Doing our own anthropometrics and hemoglobins.

Physical data collection.

All of the signatures required for certification.

Fewer signatures will be required with M-SPIRIT.

The number of signatures required.

Fewer signatures will be required with M-SPIRIT.

All the paper charting in addition to imputing information into the computer, including plotting graphs and nutrition notes to prove quality services to State on review.

M-SPIRIT is a paperless system. M-SPIRIT plots graphs so staff will not have to do that.

Charting.  I find myself performing far more education than I seem to get in the progress notes, but I still find charting in the progress notes, especially givens such as checking ID and distributing checks each appointment that the participant comes in for, discussing with participants the growth charts when new measurements are taken, just for example.

Putting certifications in the computer, certifications are required, but all of the documentation takes time.

M-SPIRIT is a paperless system. All documentation will be in the computer, no more double-entry.

Duplication of processes on paper and in computer.

M-SPIRIT is a paperless system. All documentation will be in the computer, no more double-entry.

Documentation, which hopefully will be improved by M-SPIRIT.

M-SPIRIT is intended to be a paperless system. All documentation will be in the computer, no more double-entry.

Documentation of all aspects.

M-SPIRIT is a paperless system. All documentation will be in the computer, no more double-entry.

Charting (not a time-waster but very time consuming).

M-SPIRIT is a paperless system. All documentation will be in the computer, no more double-entry, growth grids will automatically be created by the system (personnel will not have to hand-plot).

Forms that participant fills out don’t correlate with questions in the computer so time is taken to interview the participant to complete the data for the computer, for example, pregnant woman:  how many years of education and estimated date of delivery; child over 1 year of age:  birth weight, birth length, and breastfeeding information.   If participant has gone to waiting room or to change a diaper, etc., while the staff enters data, participant must be tracked down before appointment can be completed.

The certification process is very time consuming and distracts from nutrition education.  The frequency of certification required (by Feds) for stable children seems excessive.  Could we work with the Feds to allow children to be certified for one full year like infants?

Nutrition and/or breastfeeding education that is necessary for the integrity of the program.

The State has not updated of its nutrition education materials in 20 years, so we spend a lot of time researching and designing up-to-date materials.

Making up new green folders because the main office doesn’t have any in stock.

Two of our computers are “scrambling” almost daily. Better equipment would save us a lot of time.

Computer hassles.

Initially, M-SPIRIT will probably cause “computer hassles”. But after users have been trained, M-SPIRIT should reduce computer hassles.

Having to back-up the computer daily.

Since M-SPIRIT files will be maintained at the State Office, WIC files will not need to be backed up.

Lead agency responsibilities including remailing, answering questions, putting out fires caused by misunderstandings, pacifying satellite clinics because fiscal reimbursement takes so long.

Regional responsibilities.

Staffing and all related issues.

Retailer responsibilities.

M-SPIRIT will allow locals to enter the data online. Locals will not need to send in the data because the State Office will have access to it as soon as it is entered into the system. Retailer responsibilities at the local level will still exist.

Retailer training and monitoring.

M-SPIRIT will allow locals to enter the data online. Locals will not need to send in the data because the State Office will have access to it as soon as it is entered into the system. Retailer training and monitoring at the local level will still occur.

Annual retailer monitoring. (2 comments)

M-SPIRIT will allow locals to enter the vendor monitoring data online. Locals will not need to send in the data because the State Office will have access to it as soon as it is entered into the system. Retailer monitoring at the local level will still occur.

It has been very consuming to educate the stores and participants on the approved food list changes.

Having to read numbered memos from the State which do not pertain to my duties.

Correspondence and reporting to and from the State WIC office.

M-SPIRIT will enable some data (like vendor monitoring), entered at the Local level, to be available at the State Office as soon as it is entered.

Putting time studies in the computer.

The time study is still too time consuming.

Filling out time study quarterly. (2 comments)

Quarterly time studies done for whole month, tracking who days and then recording in computer.

Figuring up time studies on a quarterly basis.

Farmers’ market check stubs must be manually completed with the state issued, staff issuing, participant ID and category on each stub (twice per participant since each participant would receive $16 in WIC FMNP checks).

Farmers’ market vendors (farmers and market masters) must sign application to participate, a contract and a training verification.

Farmers market requirements without administrative funding.