SIGNED FINAL_6-13-2022 WIC MOU agreement with GHC of SC WI

MEMORANDUM OF UNDERSTANDING

BETWEEN

Group Health Cooperative of South Central WI (“HMO”)

AND

Sauk County Health Department (“Local WIC Agency”)

The intent of this Agreement is to collaborate between Sauk County Health Department (“Local WIC Agency”) and Group Health Cooperative of South Central Wisconsin (“HMO”) regarding members of Group Health Cooperative of South Central Wisconsin.

The Local WIC Agency agrees to:

1. Cooperate and communicate with HMO to ensure appropriate services of WIC participants of the HMO.

1. Make available to HMO members non-billable services which may include one or more of the following:

• immunization screening;
• nutrition services and supplemental foods;
• breast feeding promotion and support;
• body mass index identification;

Local WIC Agency shall only provide those services to HMO members as determined appropriate at the time of the WIC visit.

1. Refer to and coordinate services with the primary care provider (PCP) of the member as needed according to WIC policies and guidelines, using signed consent when required per WIC confidentiality policies.

1. Give appropriate assistance to member who expresses difficulty in gaining access to HMO and/or to the PCP.

1. Encourage members to seek medical care through HMO.

1. Provide agency contact information to the HMO and notify the HMO of any changes.