The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is an American federal assistance program of the Food and Nutrition Service (FNS) of the United States Department of Agriculture (USDA) for healthcare and nutrition of low-income pregnant women, breastfeeding women, and children under the age of five as part of child nutrition programs. Their mission is to be a partner with other services that are key to childhood and family well-being. WIC serves 53% of all infants born in the United States.
The basic eligibility requirement is a family income below 185% of the federal poverty level. Most states allow automatic income eligibility, where a person or family participating in certain benefits programs, such as the Supplemental Nutrition Assistance Program, Medicaid, or Temporary Assistance for Needy Families, may automatically meet the income eligibility requirements.
History
The WIC Program began as a pilot program through an amendment to section 17 of the Child Nutrition Act of 1966 and passed on September 26, 1972. The legislation, P.L. 92-433, sponsored by then Senator Hubert Humphrey, (D) of Minnesota, established the Special Supplemental Food Program for Women, Infants, and Children (WIC) as a two-year pilot program. Eligibility was limited to children up to age four and excluded non-breastfeeding postpartum women. By the end of 1974, WIC was operating in 45 states. On October 7, 1975, WIC was established as a permanent program (P.L. 94-105). Eligibility was extended to non-breastfeeding women (up to six months postpartum) and children up to five years of age. Eligibility was based on income, life stage, and nutrition risk. In 1978, P.L. 95-627 defined nutrition risk and established income eligibility standards that were linked to the income standards associated with free and reduced price school meals. Another income standard change took place in 1989, when P.L. 101-147 established similar income eligibility for Supplemental Nutrition Assistance Program (SNAP), Medicaid, and AFDC participation, thus lowering the WIC income standard and simplifying the application process. WIC began to promote and support breastfeeding women in the late 1980s, and in 1989 Congress mandated $8 million be used specifically for that purpose. Also in 1999, the WIC program standardized nutrition risk criteria for program eligibility and began assigning individual nutrition risk priority levels.
In December 2000, the White House issued an executive memorandum authorizing the WIC program to begin screening clients for childhood immunization status. The motivation for this was that WIC had the access to the greatest number of low-income children and thus had the greatest potential for helping immunization rates. They also directed that immunization screening and referral become a standard part of WIC certification. It mentioned that the new WIC minimum immunization screening and referral is only for use in the WIC program. Across WIC programs, it has become standardized as an accurate, efficient and appropriate screening and referral process. WIC state and local agencies must coordinate with the providers of immunization screening.
Then, in 2004, the Breastfeeding Peer Counselor Initiative was launched in which women with breastfeeding experience became counselors for women learning how to breastfeed. Five years later in 2009, the USDA introduced a new food package with foods consistent with the Dietary Guidelines for Americans as well as establish dietary recommendations for young children. In addition, mothers who exclusively breastfeed receive more healthy foods.
Eligibility Applicants to the WIC program must meet eligibility requirements in four areas: (1) categorical, (2) residential, (3) income, and (4) nutrition risk. The categorical requirement simply means that each participant must fall into one of three major categories: Women: Pregnant (during their pregnancy and up to six weeks after birth or at the end of the pregnancy) Postpartum (up to six months after giving birth or end of pregnancy) Breastfeeding (up to their infant's first birthday) Infants up to their first birthday Children up to their fifth birthday Income To be eligible on the basis of income, applicants' gross income (i.e., before taxes are withheld) must fall at or below 185 percent of the federal poverty line. State income falls between 100 percent and 185 percent of federal poverty guidelines, though most states use the maximum guideline. This is approximately $45,000 annually for a family in the contiguous US since 2016. Residential Must be a resident of the state to which they are applying for assistance. Nutrition risk Must have a nutritional risk assessment by a qualified health professional (physician, nurse, or nutritionist). The Nutritional evaluation is based on height, weight, and growth assessment; hematocrit or hemoglobin levels; general health history; and a diet
Services
General services Once applicants meet the eligibility requirements, they can expect to receive WIC assistance in the following four areas:Orange County Health Care Agency. (2011). Public health services. Retrieved from http://ochealthinfo.com/public/nutrition/wic
Supplemental food Food checks or an EBT card are issued to program participants that allow them to buy nutritious food that help them meet their needs at stores that have contracted with the government to accept these checks in exchange for merchandise. Formula WIC Laws and Regulations state, infant formula can only be changed from a non-contracted brand by medical documentation. The formula vouchers provided to the participant are not selected based upon nutritional or health benefits but upon lowest bidder status: "Competitive bidding means a procurement process under which FNS or the state agency selects a single source (such as a single infant formula manufacturer offering the lowest price), as determined by the submission of sealed bids, for a product for which bids are sought for use in the Program." Nutrition education WIC participants are offered free health and nutrition education classes which help them understand their specific nutrition needs and learn about health prevention and improvement strategies. Access to healthcare and other social services Program participants receive guidance and assistance in accessing other important services such as prenatal programs, immunizations and child clinics, and drug and alcohol treatment programs. Breastfeeding support Program participants also receive guidance and support materials from Certified Lactation Educators about the benefit of breastfeeding and proper breastfeeding techniques.
Nutrition education and anemia screening
Nutrition education ranges various topics including healthy eating, appropriate infant feeding, and breastfeeding. Additionally, the WIC program also screens for anemia in participants over 12 months old. Depending on the state, nutrition education is provided via a Registered Dietitian, an individual with a bachelor's degree in nutrition or related field, or another certified professional authority. WIC agencies are required to stress the long-term benefits of nutrition education, although participating in this education is not compulsory for WIC recipients.
Check/voucher and EBT card WIC participants often receive a monthly check or voucher, or more recently an EBT card. The USDA implemented new rules in 2006 that required foods to be more price-competitive. This has resulted in the closure of many "WIC Only Stores". Formerly, these stores charged the maximum permitted under the program, charging up to 16% more than regular stores for the same food. However, the WIC program is one of the most cost-effective government programs. A study of birth outcomes showed benefit-to-cost ratios ranging from $1.77 to $3.13 in Medicaid costs saved for each $1 spent on WIC. Citing:
The WIC check/voucher is a specially designed check that is compatible with retail point-of-sale check readers and printers. The front of the check displays the recipient's name and recipient number, a begin use- and an end-use date, a list of allowable items to be purchased with the check/voucher, including the quantity and/or maximum weight of the allowed items listed. The WIC recipient can choose if they want only some or all of the items listed on the check. The check also has an area for the cashier to enter the sale total, and an area for the recipient to sign the check/voucher at the time of use. The checks make use of MICR for enhanced security and ease of processing.
Alternately, many states (notably Texas and Nevada) have moved away from a paper system of checks and vouchers. The conversion of the WIC program to EBT cards has automated a great deal of the process and provides better care for the children and mothers currently using WIC. The cards are similar to consumer credit/debit cards but are exclusively used for purchasing WIC-approved items.
Items provided The food items provided by WIC are juice (single strength), milk, breakfast cereal, cheese, eggs, fruits and vegetables, whole wheat bread, whole grain items including brown rice and tortillas, canned fish (for exclusively breastfeeding mothers), legumes (dry/canned), and peanut butter. The program also provides tofu, soy milk, and medical foods for children and women with various metabolic or other diseases. Foods such as tortillas, brown rice, soy-based beverage, canned salmon, and a wide choice of fruits and vegetables are intended to provide state agencies flexibility in prescribing culturally appropriate food packages.
Organic fruits, vegetables, legumes and grains are covered under WIC while organic milk, cheese, juice, peanut butter and eggs are not covered under the program. Some organic forms of WIC-eligible foods (e.g., milk, eggs, cheese) meet the nutritional requirements set forth in WIC regulations and are therefore authorized. However, WIC state agencies are responsible for determining the brands and types of foods to authorize on their state WIC food lists. Some state agencies may allow organic foods on their foods lists, but this will vary by state. The decision may be influenced by a number of factors such as cost, product distribution within a state, and WIC participant acceptance.
WIC certification visits In many state programs, for a WIC certification and health screening process, the staff advises parents to bring their child's immunization records. For some state programs, the screening and referral will occur at either client check-in, food instrument distribution, or during referral part of certification. They also provide the parents of their child's immunization status as well as provide educational materials on the different immunizations. For families in the community, local WIC agencies should be able to identify providers who offer immunizations in the community. At the state level, the WIC agencies can choose to document immunization screening and referrals, along with many other optional activities. These other activities include making appointments for immunizations, making copies of immunization records, entering immunization records into a registry, and providing other educational material.
Funding
The WIC program is primarily funded through two separate federal grants: the food grant, and the nutrition services and administration (NSA) grant. Total funding increased from 2009 to 2011, but has since gradually decreased.