WIC: a look at an award-winning program – Special Supplemental Food Program for Women, Infants and Children
WIC A Look At An Award-Winning Program
In a management improvement effort known as “Focus on Management,” federal, state, and local WIC managers are looking at ways to achieve several key goals.
One is targeting WIC benefits to high-risk mothers and children, who are most in need of WIC services. Another is integrating WIC with other health services and combining appropriate records to make following participants’ progress easier and more effective.
Still other goals are better managing administrative costs and improving vendor management by making sure food stores authorized to accept WIC vouchers are carefully selected, trained, and monitored.
For 13 years, WIC–officially known as the Special Supplemental Food Program for Women, Infants, and Children–has been providing food and nutrition education to low-income mothers and children whose health may be jeopardized because of inadequate diet.
Through Focus on Management WIC managers are taking a closer look at what works best at the state and local levels and sharing information on successful approaches.
The following article looks at Pennsylvania’s WIC vendor management program, for which the state has received national recognition. Special training helps vendors understand how WIC works. Here, Vanessa Mosee, vendor manager for Philadelphia WIC agency North, Inc., shows a group of vendors what information is included on WIC participants’ identification cards.
Is A Leader In
Food retailers play a vital role in making WIC work. By stocking the appropriate WIC foods and exchanging them for participants’ vouchers, they help make sure mothers and children get the food they need for good health.
The majority of food stores are eager to follow program rules. But those who overcharge for WIC foods, exchange vouchers for cash, or sell unapproved or nonfood items, tap program resources.
In Pennsylvania, a relatively new vendor management system is ensuring that WIC food dollars benefit only participants. Limiting the number of stores authorized to accept WIC vouchers is an important part of the new system.
“We felt that giving food stores open access to the program, which means no standards of performance or desired qualifications, did not result in the best service to participants or the most effective use of food dollars,” says Mike Schappell, retail store coordinator for the Pennsylvania Department of Health.
“In the past, Pennsylvania did not have a strong vendor program, but since we began limiting vendors 2 years ago, we’ve eliminated a lot of problems.”
To put the new system into effect, Pennsylvania officials estimated the number of vendors needed to provide adequate service to the approximately 150,000 participants the state serves monthly. Geographic features and participation totals were used to arrive at a ratio of one vendor for every 75 participants.
Sixty-five of 181 vendors who applied last year were not authorized either because the number of vendors in their service area exceeded the state’s new participant-vendor ratio or because they did not meet standards for participation.
During the past few years, Pennsylvania has reduced the number of vendors by 24 percent, without causing any undue hardship to participants.
“Using limitation criteria has allowed the state agency to better control the vendor population,” says Pat Dombroski, regional WIC director for the Mid-Atlantic regional office of the Food and Nutrition Service (FNS), the federal agency that administers the program nationally. “Pennsylvania tailors the vendor population to program and participant needs.”
In addition to federal approval, the state has also won support for its criteria system from vendors and the Pennsylvania Food Merchants Association. In fact, the retailer group assisted in developing the policies.
prices are factors
With experience, Pennsylvania WIC managers have modified and refined the limitation criteria to accurately identify fluctuations in the number of vendors needed. They’ve also identified vendor characteristics that correlate with business integrity, exceptional service, and low probability of abuse.
A store must have fair prices, a variety of food items, and, when applicable, a good past performance as a WIC vendor to be selected or to remain in the program.
“Selection criteria insure that a store has competitive food prices, is sanitary, properly stores food, and meets minimum requirements for inventory and operating hours,” says Schappell.
Considerable research goes into evaluating competitive prices. Pennsylvania collects prices from all vendor applicants at the same time and compares vendors’ price to one another.
Price comparison has contributed significantly in reducing the cost of WIC foods. In Pennsylvania, the average monthly cost of WIC foods is $26.40 per participant, $5.43 below the national average.
State managers have found chain store prices for WIC foods to be the lowest and operators the least likely to abuse the program. Sixty-two percent of the 1,700 WIC vendors in Pennsylvania are chain stores.
Each state’s WIC program is required to monitor a certain percentage of its food vendors to be sure they are not abusing the program. Pennsylvania’s new system makes monitoring and sanctioning more effective in several ways.
“Because Pennsylvania has a manageable number of vendors, it monitors them at an acceptable rate and covers monitoring costs,” says FNS’ Dombroski. “This enables the state to more actively pursue sanctioning those vendors who do abuse the program.”
A vendor can be disqualified from the WIC program for from 1 to 3 years depending on the nature and extent of abuse. A civil money penalty also may be assessed.
“Pennsylvania was the second state in the nation to establish a civil money penalty policy for sanctioning abusive vendors,” says Dombroski.
In deciding whether to disqualify a vendor, state officials consider whether the vendor is needed to meet participants’ needs in a particular area. If so, they may impose a civil money penalty in lieu of disqualifying the vendor from the program.
Vendors who are sanctioned have the option to appeal through a fair hearing. Pennsylvania won 93 percent of the appeals made last year, showing that the monitoring system is successful in identifying grocers who should be sanctioned.
An added bonus is that the system saves money. Since it’s less costly to monitor a set number of carefully selected vendors, Pennsylvania has been able to channel operating funds to other administrative areas.
While monitoring and sanctioning are useful tools, state managers feel the best way to protect program dollars is to prevent abuses before they occur. To do this, they provide ongoing training to all WIC vendors, who are required by their contracts to attend training on program regulations.
“Since 1986, all approved WIC vendors have been required to attend one training session each fiscal year in order to maintain their authorization,” says Schappell.
“We’ve developed special training aids, such as a videotape, to show vendors exactly what foods are allowed and how to process and redeem food vouchers.”
The materials also explain what instructions local WIC staff give participants to help them understand how to use WIC vouchers.
During the training, local agency instructors emphasize the nutritional aspect of WIC. They explain that participants receive specific foods, such as milk, juice, eggs, cereal, cheese, peanut butter, and infant formula, for health reasons and that nutrition education is also provided.
“Vendors don’t always understand the importance of not allowing participants to buy non-WIC food items,” says Schappell. “We tell them we are spending millions of dollars in federal and state funds in their grocery stores and to consider this an investment in children’s health.”
Vendors are asked for their comments after completing the training. “The overall response from the vendors has been positive,” says Schappell. “They have said the training sessions are long overdue.”
state a leader
Pennsylvania has received national recognition as a leader in vendor management.
During the fourth annual conference of the national WIC directors last March, Assistant Secretary of Agriculture John W. Bode presented awards to six WIC agencies that exhibited excellence in managing the program.
Pennsylvania was honored that day for “setting clear standards for selecting WIC program food vendors and monitoring their performance, thereby achieving better service to participants at a lower cost.”
Working more closely with vendors has made a big difference. “We have had more success with vendors in the past 1 to 2 years because we’ve been more visible to them,” says Mike Schappell. “We require more of them, and we make sure they understand the program.”
For more information, contact: Mike Schappell Retail Store Coordinator Pennsylvania Department of Health Division of Special Food Programs P.O. Box 90 Health and Welfare Building Harrisburg, Pennsylvania 17108 Telephone: (717) 783-1289
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