Strengthening Public Health Connections for Maryland WIC Families


Impact Statement: 
The Maryland Department of Health and Mental Hygiene partnered with its local health departments and WIC clinics to increase the number of WIC clients referred to and receiving appropriate services to meet their needs.
The Office of Population Improvement at the Maryland Department of Health and Mental Hygiene (DHMH) submitted a quality improvement (QI) initiative with the goal of better understanding the referral process in Women, Infants, and Children (WIC) program clinics (specifically, referral to public health services [PHS]) and increasing the number of WIC clients referred to those services who actually receive the service. Historically, there has been no systematic tracking process for identifying those who have received a service to which they were referred, and communication between the WIC clinics and PHS were nearly nonexistent. More than 10,000 referrals are given to Maryland WIC clients for PHS each month (state-wide), with no way to determine whether those referrals were received. This project worked toward not only connecting WIC clients to PHS, but also enabling PHS to reach out to the WIC clients to make the referrals more effective (lessen the burden for the WIC clients). Prince George's and Montgomery counties participated in this pilot project. The project focused on four PHS that the WIC staff and DHMH identified as being integral touch points for WIC: immunizations, lead testing, comprehensive women's health, and smoking cessation. WIC staff make referrals in these four areas, to either the local health department (LHD) or to community health partners. The team tested four individual improvement hypotheses (one for each area) over 10 months (from December 2012 to September 2013), to identify the best ways in which to increase the chances of a WIC client receiving the service to which he or she was referred. Accomplishments of this project include developing a comprehensive women’s health training module for WIC staff, implementing the Fax to Assist (FTA) smoking cessation program within participating WIC clinics, and gaining a clearer understanding of the gaps and uses of WIC and PHS data.
Organization that conducted the QI initiative: 
Maryland DHMH

Silver, K. Public Health Quality Improvement Exchange. Strengthening Public Health Connections for Maryland WIC Families. Thu, 04/09/2015 - 10:11. Available at Accessed July 24, 2024.

Submission Status: 
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Submitted by ksilver03 on

We hope that PH partners working with WIC programs can learn something from this initiative

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Submitted by on

Thanks for the great summary of your work. It is of particular interest that there is not currently the capacity to do lead testing. In Montana there is a priority to increase testing of Medicaid children but this is generally an unfunded initiative and finding the capacity/resources to support this work is very hard. I would be interested in hearing any progress around this issue if your department decides to address the lead testing of WIC children in the future.

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Hannah Silveus, Prevention Health Specialist
CDC Public Health Associate

RiverStone Health
123 South 27th St. | Billings, MT 59101

Submitted by vlamers on

Really love this initiative - especially since it's right in my backyard. I think it would be crucial to have follow-up from the referrals. We know that one-sided referrals for high-risk patients are not very effective.

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