Please check the category that most closely describes you (optional):	After reviewing the PowerPoint presentation by Joan Bowsher on "Overview of WIC Program" from the February 22, 2008 meeting, what questions or comments come to mind?	After reviewing the handout entitled "Funding Formula Explanation", what questions or comments come to mind?	After reviewing the "Report from Mary Pittaway", what questions or comments come to mind?	What is one good thing about this process so far?	What is one not-so-good thing?
Response	Open-Ended Response	Open-Ended Response	Open-Ended Response	Open-Ended Response	Open-Ended Response
County Employee	Why is WIC not with Food Stamps etc. instead of MCH? Why is WIC not a Bureau or Division of it's own? It is in fact larger monetarily than most other programs and has vastly different rules and requirements. Why can the State not absorb IT costs or cost allocations as a supportive measure (financially) for the program. It could be viewed as an in-kind type of support for the program by the State and recognize WIC's Economic  impact on the state. Why does the Stae office now have more personnel when the point of regionalization was for them to be able to do more with less?	Where is Montana in the "Fiar Share" picture? for Food dollars.Did our food dollars rise enough to keep up with inflation or to off set the costs of inflation? Since Oa funds are based on varying needs of  the State agency why was an OA request submitted to remodel the Yellowstone clinic? That was done once in the past and that is one of the reasons OA request were to be submitted to MAWA  to be consolidated with like proposals and be reviewed for benefit to the entire State not individual interests before being forwarded to the State. This was an attempt to assist the State. Are there any further anticipated unspent funds for reallocation?	Appears to be many areas for consolidation , reorganization, and restructuring of processes. Seems to be an inordinate number of subcontracts and agreements. Are these really and truly necessary or could these not be handeled once at the State level?	The ability to have all these items out in the open and looked at honestly. The actual possiblity  to make some positive, meaningful changes to one of the States most valuable programs for the people of the State.	It is alot of work!!!
County Employee	None - Very basic overview	If it is so straignt forward why so many different funding formulas?	I am clueless what this is and were the data came from.	Information is being shared.	There is a lot of information to cover.
County Employee	good orientation	Interested in how much of the NSA money is kept at DPHHS.	This amount of required busyness is absurd and must be curtailed asap	good prep, good tone, good facilitator	We are doing it again and it is hard to be hopeful while struggling at the local level at the same time
County Employee	Does Local funding based on the size of the region take in to mind the number of clients being served?  NSA does look at projected participants.	Does the funding formula take in to mind travel and additional operating expenses to provide a portable department?	What are the priorities and what time wasters can be eliminated?	Participants are being served.	WIC Directors appear stressed and have not found balance between providing services and documenting the services provided.
County Employee	Under local funding, it was mentioned that other factors such as size of region and travel are taken into consideration. However on the budget, participation is the only factor shown as a criteria except for additional money to be a lead agency. What are the criteria used for size and travel and how are they adjusted for on the budget? For those with a lot of area to cover in less populated counties this is an important factor to look at. Clients in the more rural areas seem to be valued less than those in the more urban areas of MT.  Related to this is the structure of regional agencies managing other local agencies. Based solely on numbers it appears easier to discount or reduce services so that the larger lead agency can survive. In most cases the lead agency is able to control the finances including a % for administrative and the counties that are attached to that region see their funding diminished to the point of providing fewer and fewer direct services. Under the new system of formula funding per participant all agency sizes are treated the same so that smaller agencies with more travel and area to cover are not given any extra money to deal with and rather are forced to cut back or eliminate WIC clinics. Overall, we need to determine what our goal is in providing services to Montana WIC participants: is it to provide for the greatest number in the larger clinics with the demise of smaller clinics or can there be some way to compromise to allow services to continue to as many Montanans as possible throughout the state. Also the system of fewer lead agencies has caused a great deal of stress in terms of meeting the expectations for the lead agency, i.e. overseeing another county's budget and then struggling to get everything done that is required to be a competent lead agency. It would be good to get an accurate assessment of how many hours and dollars are actually spent by lead agencies in managing their associated local agencies. Are we really being more efficient with our dollars than was being accomplished when the state agency did the monitoring? The irony is that when lead agencies were given the responsibility of monitoring their associated agencies, the extra time amd money saved by the state WIC agency who had fewer monitoring visits to make was not passed on to the lead agencies. In fact, the costs of the State WIC agency has gone up and fewer dollars are being funded to the locals to accomplish what they they had to do in providing WIC services in addition to the added administration requirements.	None	Great overview of a well coordinated large agency.	Opportunity to discuss issues that have been a concern. Opportunity to hear local agencies and the concerted voice of MAWA reflecting what many have been experiencing and put out for discussion is a good starting point.	Uncertainity whether effective change can come about as a result. Will the voices of the local agencies really be heard and respected?
County Employee
County Employee	Let's be true to the goal of serving as many participants as possible, but keeping in mind that participants in all areas of our state need to be served.    Does local program funding truly take travel into account?  I have never heard this.		Preparation of this report appears to be time-consuming.  I am not sure what value most of the information has, as fas as being "need to know" information.  It is interesting to look at, however.	Great communication, both in sharing minutes and requesting input.	Ooops, needed more time to carefully review the information and get this survey done!
County Employee			It reminds me how cumbersome WIC feels,  and how challenged WIC staff are to learn all the details, apply all the details and constant changes while keeping WIC a positive program, a welcoming program for clients (and staff).	Feeling there is a voice to question assumptions, and that, hopefully, with the range of representation on the panel, you can look beyond  the automatic responses.	Difficult for the majority of WIC personnel to have a voice,  or see this process as it unfolds.
County Employee	If the “primary goal is to provide quality WIC services to the greatest number of participants possible.”  And if our services are to be client centered (VENA training Feb.), someone needs to be looking at what that means.  Who is ensuring (program specialist, state?) that our goals are being met?  At the local level, we have seen an exponential increase in state regulations (to be met by WIC offices) without providing money, staff, or time to meet the regulations.  WIC CPAs have a hard choice to make, spending time with clients or compliance with the large quantity of state regulations.  There needs to be a balance found that does not punish WIC employees or the client.  How can we meet all of the State regulations and still have time to spend with the client?	I found the “Funding Formula” incomprehensible.  I read it carefully several times and still had no idea what specific criteria is used to fund our clinics.	The first question that came to my mind is, why does Missoula have 327 clients per FTE, and Helena has 428 clients per FTE?  (In Helena we have 2.8 FTEs and 1200 clients).  This goes back to the funding formula.  How does it work?  Is it fair??	That someone is finally looking at the WIC process.  Is it fair and reasonable??	From observing this process so far, it is clear that there is no consistency with funding from county to county.
County Employee	Need some fill in the gaps for slides.  Additional talking point notes would be helpful.	How much latitude do we have in determining funding to particular sites in Montana and how do we determine the cost effectiveness of programs taking into account accessible services, travel and administrative cost.	Interesting.  It would be good to see similar data from other clinics but we need to assure that we compare apples to apples and that there is no inflation of numbers.  These look like estimated numbers and I wonder if a computerized system could track exact numbers from all programs.	Allows us to focus attention on WIC and really take time to have a thoughtful and comprehensive approach to funding.	Lots of time, expense and angst among WIC staff.
County Employee	Some questions never get answered, like was any money saved by regionalization efforts, whaere are the minutes from the very first meeting in the Cogswell building September 2007 when we were told the goal of the process was to help with funding next year (only to be told later the fuding would not change for 2 years)	funding formula is quite complex and difficult to understand	Wow, the WIC staff in Missoula does a great deal of services for their participants, it reads like the life of a public health nurse	we are receiving the minutes from the meeting even if we are not attending	that more local WIC staff have not been able to attend, and that it is starting so late and some questions never get answered like when we asked about the funding for next year and was told the  current funding would not change for 2 years
County Employee				The fact that we are having this group and that it includes lead public health ofifcials and wic directors	The fact that information is set out without cross copying everyone; WIC Directors got questions a few weeks ago and Health directors weren't sent the questions.
County Employee	Without being present at the power point presentation - no questions come to mind - we've gone over this before.		The document that Mary presented before really covers every	It's a start - there's not been one before.	Is there enough time to cover all the issues (July)?
County Employee	What  can be changed about WIC is some state plan regulations?  For example,  high risk definition.  Also,  approval of non-contract formula.  Also, the ability to add additional risk codes after the certification period.	I don't understand it.  I would like further clarification.	Ihaven't been able to attend any of the WIC sudies group to keep Buttes participant report up.  Does she also have this report broken down to monthly?	I didn't know the federal regulations guidance versus the Mt. state plan is different.
County Employee	Re the State Plan:  why does MT need more stringent regulations than what the federal regulations require?  This does not seem to ensure quality, but instead creates barriers and obstacles for patients and for programs.  Regionalization has decreased the number of WIC programs from 40 some to 27.  Tribal programs remain at 7 throughout.  What are the cost savings from this regionalization?	A question about the re-allocation funds:  are these funds re-distributed evenly out to the programs, or what happens to this funding?	Is this data tracked electronically?  Is there a software product that helps generate this kind of report?	The communication.	Not sure.
State Employee	It was not helpful	There has to be a more readable way of presenting this information.	It was not helpful	The involvement of all the participants	Unreadable information
Hospital or Other Non-Profit Employee	Mostly for a number of participants the meeting was a waste of time.  General information is good but should not have been the majority of the meeting.  Problem solving and progress needs to be included.	This was not helpful as it did not show how the state distributed the funds to locals, how much was kept for administration etc...	There was good information.  No differentiation was made about what costs increased as a result of becoming a lead agency	The state is willing to include local input through survey process.	There was no discussion or problem solving allowed at the first meeting which was frustrating for participants who actually wish to begin planning for improvement.  A request for suggestions were solicited but there was no discuccion on them.
State Employee	Good info.	No questions	Local implementation is complex, but likely differs from site to site.	We've started!
State Employee				We are working toward a better system.