Please check the category that most closely describes you (optional):	After reviewing the documents on the website for the first and second WIC Futures Study Group meetings, please tell us something you have learned that you didn’t know before.	When you consider the WIC service delivery SYSTEM, where are the weaknesses or places where the system seems to break down?	What would be the best way to divide up the WIC nutrition services and administrative (NSA) funds?	How can the WIC Futures Study Group build accountability (both state and local) into the system so that improvements can be made and acknowledged?	What would be the foundation blocks of the “Most Excellent WIC Program in the Country?”
Response	Open-Ended Response	Open-Ended Response	Open-Ended Response	Open-Ended Response	Open-Ended Response
County Employee	how much more state asks above what feds require	1) transferring participants within montana 2)providing RD coverage for high risk  3)  bureaucracy winning over meeting participant's needs 4) finding qualified job applicants who do not require significant training to meet WIC requirements and paying enough so they will stay  5)every clinic reinventing the wheel in how to chart, how to provide nutrition education, and just deliver services 6) WIC is getting less open to participants, staff have difficult time presenting the positive benefits of WIC vs the "hassles"		Can locals participate in decisions of what is required/what is reasonable and do-able in respect to  what is required.  Can there be an on-going "board" that includes some of the people at this meeting and not just 'WIC ,  so we can keep sight of how to serve Montana.	1)all communities have access to wic  2)collaboration bewteen local agencies,  ( sharing ideas, resources, staff)  3)addressing the most important health prevention areas (childhood obesity)
County Employee	That the proportion of money going to local agencies compared to total admin costs for MT have dropped from 77% to 68%; the concept of "WIC certifiers" makes so much sense, and is allowed under the regulations;	The archaic computer system; duplication of processes--both paper and computer; lack of communication between WIC IT & State IT;	Not sure, BUT establishing good two-communication with the local levels on-going instead of memo driven decisions coming down to the locals from the state would be a good start.	Establishment of clear, concise MOUs (eg:  WIC--IZ program is a good example) so everyone is on the same page; seek better consistency between state regulations and federal regulations;	stop micromanagement of the program;  get rid of unnecessary regulations; drive WIC from the local agency up, not the state agency down;  make it participant-centered and get rid of barriers to service; remodel the funding allocation formula to provide WIC to all populations--frontier, rural & urban.
State Employee	Montana receives funding at a bit higher rate than some other states because of our "fair share" status.	Lack of clear communication of expectations between state agency and local agencies, need for an updated computer system, lack of trust between some local agency and state agency staff (attitude of "us vs. them" rather than working together to solve problems)	I don't feel I know the best way to divide up funds.  Local agencies must be provided with more funding to meet increasingly rising costs as they are the frontline providers of WIC services.  The indirect rate paid at the state level must be reviewed - Why has it quadrupled in recent years??  How does this compare to the increased rate for other Programs - MCH, Women's and Men's Health, etc.?		Provision of excellent customer service including respect for our participants and our state and local agency staff, Adequate funding to provide quality services, Well-trained staff who are proud of the job they are doing
County Employee	Cost of DPHHS administrative services	Lack of funding to locals to carry out State Plan for participants	not sure	not sure	we need to be adequate before we can be excellent!!
Other	The dislike of Time Studies seemed to be a common thread in the respondants in the previous survey.	Disturbing the CPA to change food packages, and the CPA unable to change risk codes after a certification is done.			A good computer system that is responsisve to the needs of clients and employees.  A way to service clients when traveling long distances to get to a clinic provides an undue, or sometimes overwhelming  burden for clients
County Employee	Wasn't aware we still needed documentation to verify pregnancy.	I think the first appointment with all the paperwork, dos and don'ts become overwhelming to clients.		Uniformity of forms, information sent both directions in a timely manner.	Providing services to more local areas.  Increasing caseloads
County Employee	Rationale is sound for most MT state WIC requirements that are not federal WIC requirements	Communication between State WIC and local program staff - is the state listening?  i.e., numerous local agencies sent comments about lead agency finances, which were totally ignored in 3 budget revisions.	With shared input from all interested staff.	This is difficult to answer without specifics ... however, good communication is essential.	Quality nutrition education services to all interested eligible participants.   Supplemental foods.   Friendly compassionate staff who believe in the WIC program.
State Employee	This might turn out to be valuable.	The state WIC department has no budget. How can anyone effectively manage a program when they have no idea what money there is or how much has been spent on what?  That must be addressed.	In contracts, reward efficiency, accuracy, and compliance with program. Warn and educate but, ultimately, punish perpetual slackers by giving contracts to entities that will produce.	Relate everything to the mission of the program. Devise a plan and meet with stakeholders regularly to evaluate progress. Act to continuously improve everything. Don't hide anything.	Accountability, honesty, inclusion, communication, transparency, competence, follow through, customer service, evaluation, feedback, smiles that come from doing something important and good.
County Employee	The magnitude of the cost allocation system. A the tricky hidden employees. The employees that are paid by WIC but not necessarily counted towards WIC FTE's.	State to locals. However is improving. Difficult to hire new employees in light of the fact that most of us can not set salaries to suit the whims of the applicants.	Fairly. Keeping in mind as Jean Licheus pointed out that there are base costs no matter how big or small you are.   The Band system seemed to work well as it allowed for economy of scale. Also we came to an agreement about 10 years ago that NSA should be divided 25% for state operations and 75% for local operations. We should share equally in the pain (decreased funding) and in increased NSA.It must above all be fair. When a clinic gets special treatment monetarily it inadvertently penalizes those that work within their alloted budgets as we thought we were expected to do.No one clinic is any better or entitiled to anymore than any other clinic.	I believe that is part of the process we are currently engaged in. We have made a start by laying all the cards on the table. I think we need to start also with a cooperative attitude.Locals have always been willing to work WITH the state but we don't like being taken advantage of.	Fairness to the maximum degree possible, standards for basic operations,without standards you can not measure anything. We would be efficient and utilize the most up to date techniques, technologies and information. We would all be trained to the same level. OUR clients would get the best service for the least cost.We would address the most urgent health risks to our clients such as obesity in a standard fashion. We would serve all eligible clients.We would decrease formula and increase breastfeeding.
State Employee	Time takers vary from community to community	Detailed documentation required at service delivery level	Per federal directives.		Accessibility, ease of service provision, measurable indicators of nutritional health
County Employee	The federal regulation allows for staff other than RD's and RN's to make changes in the food packages	First, it is a public health service delivery system and not just WIC. Some staff seem to think there is value to providing WIC services in a vacuum and not as a part of the larger public health picture. WIC is a part of MCH because they are not "WIC participants", but public health participants. Our impact with our participants will happen when we work with them in that global concept.	Consider number of participants and for rural counties you must provide funds for travel to outlying areas and small programs. Equal access to services for all state residences regardless if they live in urban or rural areas must be considered.	I am not sure what is being asked, however accountability is a problem for state staff and not local staff.	At the local level, a staff that is familiar with the community and participants, a local staff with expertise in nutrition, knowledge of public health principles and see the participant as a whole person with many assets and needs and not just a particpant in one program.A local program that is equally accessible to all residents in the state. A state level with staff to provide IT expertise, nutrition consultant services and program oversight. The state program should be very transparent, knowledgeable of fed regulations, policies  and provide technical services to local staff such as brochures, templates for MOU's, and contracts.Finally site visits by state staff should be opportunies for improvement and enhancing local programs and not punitive. The messges from both the local and state level staffs should be consistent and  evidence based.
County Employee	The federal/state/local crosswalk had new info and clarified other info.	The system's two major weakening trends are costs are covered at the state at the expense of the local agency and clients; and there is a general problem with competence in the system in that is doesn't self-monitor, therefore it cannot adjust, so preventable problems arise and become chronic.	Release some of state funds to local pool; pay more per client locally; limit % of local funds that can go to overhead.	The current transparency is a great first step; after that, regular reports out on from the state on certain key indicators about the system's competency.	More clients receive the service with less administrative time wasters/hassle and better predictability
County Employee		communications from the state to local level	That question is more complicated than a one lined answer.	Surveys done 1-2x yr and evaluated by 3rd party	Simultaneous communication (email), serving the most needy