Transcript WIC and the Vendor Community

Food Industry Alliance
Government Relations Committee
May 15, 2013
Loretta A. Santilli, M.P.H.
Director, Division of Nutrition
Roberta Hayward
NYS WIC Program Director
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Offers nutrition education, breastfeeding
support, referrals and individualized nutritious
food packages to low-income pregnant,
breastfeeding or postpartum women, infants and
children up to age five to promote and support
good health.
Foods provided as part of a package include:
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Low or fat free milk
Fruits and vegetables
Peanut butter
Beans, peas and lentils
Whole grains – cereal, bread,
Infant formula
100% Juice
Canned fish
brown rice
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Average monthly WIC caseload
is 512,294:
◦ 125,810 (25%) women (pregnant/lactating)
◦ 121,220 (24%) infants (<1 yr)
◦ 265,265 (51%) children (2-4 yrs)
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75% of caseload is located in the greater NYC
Metropolitan region
WIC serves ~50% of all infants born in NYS
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Federal grant program (USDA)
◦ $6.6 billion in 2012
◦ NYS $550M
Eligibility: gross income limit of 185% of federal poverty level
($2,944/mo/family of 3) and presence of nutritional risk as
assessed by a WIC health care provider.
The results of multiple studies conducted by governmental
and other non-government entities prove that WIC is one of
the nation’s most successful and cost-effective nutrition
intervention programs.
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Federal sequestration has impacted the WIC
Program nationally.
The NYS WIC Program’s federal funding was
reduced in FFY 2013. Food funding was
reduced by $17M.
NYS DOH provided additional state funding to
help mitigate the shortfall.
USDA will entertain requests for additional
funds.
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In order to apply for additional federal funds,
NYS must review current practices and take
steps to contain food costs.
There are many initiatives that NYS is
currently considering.
The recent elimination of canned beans as a
substitute for dried beans, peas and lentils is
a first step.
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Eliminating the dangling quart of milk
resulting from the substitution of cheese.
Requiring the purchase of least expensive
brand for milk and eggs.
Review of the issuance of special formulas:
medical documentation, quantities, brands,
etc.
Elimination of soy beverage and tofu as
substitutes.
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Staffing changes at NYSDOH.
Taking a fresh look and policies and
procedures.
Committed to ensuring program integrity.
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A WIC vendor is a sole proprietorship,
partnership, cooperative association,
corporation, or other business entity
operating one or more stores authorized by
the State agency to provide authorized
supplemental foods to participants under a
retail food delivery system.
Each store operated by a business entity
constitutes a separate vendor and must be
authorized separately from other stores
operated by the business entity.
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Currently there are 4,400 WIC authorized vendors
in NYS.
◦ Pharmacies may be authorized as a WIC vendor to issue
formula.
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There are 5 Vendor Management Agencies
(VMAs) contracted by NYSDOH to receive and
process all vendor applications, perform
mandatory store monitoring and training, and
enter into contracts with the individual stores.
575 new vendor apps per year are processed
through the VMAs. In addition, the VMAs also
reauthorize 1,450 current vendors annually.
Vendors are reauthorized every 3 years.
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USDA is reviewing their vendor management
policies, monitoring and oversight of state
programs.
Significant changes are expected.
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Due to breaches in vendor management
oversight in California and Georgia WIC
Programs, an increase in SNAP (food stamp
fraud), and an Office of Inspector General
audit of USDA’s oversight of vendor
enrollment and monitoring; USDA is
conducting a comprehensive review of each
state’s vendor enrollment and monitoring
polices and procedures in FY 2013 and 2014.
New York’s review will be in 2014.
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The Office of Inspector General (OIG) found that the Food and
Nutrition Service’s (FNS) management evaluations (MEs) did
not identify and correct significant issues in the vendor
management processes at two State agencies operating WIC.
These agencies lacked sufficient controls to track vendor
violations and ensure timely and appropriate sanctions.
◦ As a result, vendors were not disqualified as required, and could
redeem WIC benefits during their required periods of
disqualification.
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Also, the State agency did not conduct compliance
investigations on high-risk vendors, and did not treat smaller
vendors in an equitable manner with large chain stores.
◦ These deficiencies could allow vendor violations, including
excessive charges and the sale of unauthorized food items, to go
undetected.
Women, Infants and Children (WIC) Program Vendor
Moratorium Announcement Effective March 18, 2013
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The United States Department of Agriculture (USDA) has
formally notified the Department of Public Health (DPH)
that effective March 18, 2013 the USDA will not allow the
Georgia Women, Infants and Children (WIC) program to
authorize any new vendors to participate in the program
regardless of size, peer group, or application status. This
moratorium shall apply to all new vendor applications and
additions of new stores to current agreements. Any
applications received after March 18, 2013 will be returned
to the applicant unprocessed. In addition, any application
not processed by March 18, 2013 will not be approved as
directed by the USDA.
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Some areas of review have already been
shared with states:
◦ Limiting the authorization of vendors with known
history of program violations.
◦ Review of vendor to participant ratios.
◦ Small vendors: ensuring food costs are reasonable.
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In accordance with federal regulations, NYS WIC is required
to consider the business integrity of vendors (includes
owners, officers, managers). NYS is committed to program
integrity and uses formal background checks to screen
WIC vendor applicants.
Vendor background checks are the most effective method
of front end detection to keep individuals from
participating in the NYS WIC Program who lack business
integrity and/or who have abused other government
programs.
Background checks for WIC authorization are necessary for
each store operated by the business entity because
management personnel and officers differ from store to
store.
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Approx. 10% of new apps have findings requiring
additional follow up.
The Bureau of Special Investigations (BSI)
uncovers issues in about 25% (300-350 vendors)
of vendors they review.
◦ Further follow up and potential action (sanctions, CMP,
DQs).
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BSI manages information sharing with
SNAP/USDA for approximately 300 SNAP vendors
to determine reciprocal actions needed from the
WIC side (as required by federal reg).
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USDA has reviewed NYS’s revisions to the
vendor enrollment policy and has asked a few
clarifying questions.
NYS will respond to USDA with an approval
expected shortly thereafter.
NYS has proactively taken steps to improve
processing time for vendor applications.
Vendor Authorizations
Average Number of Days to
Process Complete Application*
70
60
57
47
50
Days
61
51
49
40
40
31
30
24
20
10
0
VMA 802
VMA 803
Downstate
VMA 806
VMA 807
VMA 808
Upstate
Statewide
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Improve training and communication with the VMAs.
Instead of using “snail mail” to send the vendor application
packets from the VMA to the State, document scanning
has been implemented to transmit the information
electronically.
The vendor application is sent forward for processing as
long as the SNAP application is in process. (No longer
need to wait for the actual SNAP approval.) The WIC app
will not be formally approved until the SNAP authorization
is officially received.
VMAs are conducting the required onsite store monitoring
concurrently with State business integrity review.
Vendor Authorizations
Average Number of Days to
Process Complete Application*
50
45
44
40
37.5
35
31
31
Days
30
28
25
25
21
20
15
10
5
0
0
VMA 802
VMA 803
Downstate
VMA 806
VMA 807
VMA 808
Upstate
Statewide
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WICSIS2 and EBT
◦ USDA has approved NYS’s selection of a new webbased MIS system.
◦ NYS is developing an implementation plan.
◦ EBT implementation is expected in early 2017.
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New Foods Card
◦ Staff are compiling results.
◦ Results to be made public mid-summer.
◦ New WIC Acceptable Foods List expected early fall.
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USDA held a debriefing meeting with at a WIC
clinic that was affected by Hurricane Sandy in
Far Rockaway.
Lessons learned:
◦ Communication is key.
◦ Take storm warnings seriously and prepare.
◦ Post storm conduct reviews of vendors who
remained open/opened quickly post storm to
ensure food supply is safe.