Story by Richard Delaney, JD, MPH, Colorado Department of Health Care Policy and Financing

In 2011, the Center for Public Health Practice of the Colorado School of Public Health solicited proposals from individuals working in any aspect of public health in Colorado for financial support for a 12 month project. The funding for these projects was sponsored by the Colorado Health Foundation.

The general purpose of this fellowship is to support scholars to create novel and useful products, as well as to provide academic enrichment to those working in public health fields in Colorado to enhance their professional work.  Health Care Policy and Financing’s “Good Early Nutrition Project” was selected as one of the Scholars in Public Health Practice awards. A portion of the project manager’s salary and materials were supported with these funds.  Project staff include: Richard J. Delaney, JD, MPH, project manager in partnership with Lynn Ireland, WIC Coordinator, Colorado Department of Public Health and Environment, and Ruth Chavez, PhD, MBA, Assistant Professor, Metropolitan State College.  For more information about the program, please contact Richard Delaney, or 303-866-3436.

Richard Delaney, a Program Specialist at the Colorado Department of Health Care Policy and Financing, is a 2011 Colorado Public Health Scholar recipient. His project will develop coordination between two state agencies to help maximize the services to eligible Women, Infants, and Children.

The number of children under age 21 enrolled in the Medicaid program has increased from 279,000 in January 2010 to 328,632 in October 2011[1]. The latest data shows that 180,732 children are under the age of 5 were eligible for Medicaid as of October 2010[2]. When Colorado children become enrolled in Medicaid, they also become eligible for other assistance available in the ‘safety net’ that provides basicsupport for those most in need, including the special supplemental nutrition program through the Women, Infants, and Children program (WIC). The latest report for the WIC program indicates 120,293 individual children under age 5 participated in 2010.

In Colorado, two state agencies, the Department of Health Care Policy and Financing (Medicaid) and the Department of Public Health and Environment (WIC) both administer assistance programs and WIC provides some services to Colorado residents. Because the two programs are administered by different federal agencies and different state agencies, coordination is challenging. Colorado Medicaid is part of the programs administered by the Centers for Medicare and Medicaid Services in the Department of Health and Human Services. The WIC program is part of the Department of Agriculture. A Public Health Scholars grant will help these agencies coordinate benefits for eligible children.

The two programs have compatible goals. A child that is enrolled in Medicaid is automatically epligible for WIC services and is provided that information but there is no required follow up to confirm that the family has enrolled in WIC. Coordination between the agencies has the potential to improve the health of Colorado children and be a more efficient use of resources in the state. The Medicaid program’s benefits are essentially limited to the nutritional products for a specific child in a family. The WIC program offers a range of services including nutritional education and referral. By connecting Medicaid children with the WIC program, Colorado children will not only have the nutritional benefits, but receive counseling and screenings designed to raise healthier citizens.

Oral nutritional supplement is a covered benefit in Medicaid when there is a medical necessity. Similar supplements are available from the WIC program. The WIC program offers complete nutritional support including counseling with registered dieticians and food products for all the children in the family. The Good Early Nutrition Project (GEN-P) is an effort to promote WIC benefits to eligible Medicaid clients.

Colorado Medicaid can identify infant and child recipients that receive oral nutritional supplements. Between March and June of 2010, Medicaid provided over 3000 units of oral nutritional supplements to children under the age of 5. These supplements are in response to a medical need, not just inability to afford food. The clients that receive the supplements would benefit from receiving enhanced support on diet and nutrition that is available through the WIC program and their families might benefit from additional food assistance from the WIC program. The children themselves would possibly benefit from nutrition counseling and other services available from the WIC program. Richard Delaney is individually consulting with staff at the physicians’ offices to encourage them to recommend that the patient participate in the WIC program.

Through the GEN-P effort, the two state departments will work together to explore the role of physician recommendation on WIC participation by families receiving Medicaid benefits for nutritional supplement. While the initial impact may be small since the targeted population is less than 500 Medicaid clients, the GEN-P effort will begin exploring how Medicaid and WIC can share data about the Colorado residents they serve. The coordination will result in more efficient use of resources and more effective benefits through both medical care and nutritional counseling.


[1]Department of Health Care Policy and Financing FY 2011-12 Medical Premiums Expenditure and Caseload Report, October 2011