Need To Foster Optimal Use of Resources in the Special Supplemental Food Program for Women, Infants, and Children (WIC)
RCED-85-105
Published: Sep 27, 1985. Publicly Released: Sep 27, 1985.
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Highlights
GAO reviewed the Special Supplemental Food Program for Women, Infants, and Children (WIC), which the Department of Agriculture's (USDA) Food and Nutrition Service (FNS) operates. GAO attempted to determine how to obtain the maximum benefit from the use of WIC resources, focusing on: (1) the extent to which state and local WIC agencies attempt to target WIC benefits on the basis of need; (2) FNS procedures for targeting WIC benefits; (3) state and local WIC agencies' verification of applicants' eligibility for benefits; (4) the impact of FNS and state agency fund allocation procedures on state and local program operations and benefits targeting; and (5) opportunities to improve targeting, fund allocation, and eligibility determination procedures to maximize the beneficial impact of WIC resources.
Recommendations
Recommendations for Executive Action
| Agency Affected | Recommendation | Status |
|---|---|---|
| Department of Agriculture | The Secretary of Agriculture should: (1) require FNS to emphasize targeting as a major policy objective and guiding principle to be followed by state and local WIC agencies in managing their programs; and (2) provide technical assistance to state and local WIC agencies in developing approaches for targeted outreach and effective referral arrangements designed to increase the number of especially vulnerable individuals available to the program on a continual basis. |
Closed – Implemented
Regulations, effective October 1, 1987, satisfy this recommendation. These regulations stem from P.L. 99-500.
|
| Department of Agriculture | The Secretary of Agriculture should require FNS to: (1) include targeting performance as an area for examination in state agency management evaluations of the WIC program; (2) encourage states to consider targeting performance as a basis for evaluating the overall performance of sponsoring local agencies; and (3) use actual targeting and potential for targeting as a basis for selecting additional sponsoring local agencies. |
Closed – Implemented
FNS implemented standards which generally comply with this recommendation.
|
| Department of Agriculture | The Secretary of Agriculture should require FNS to undertake and support appropriate targeting initiatives and demonstration projects aimed at developing and testing a variety of targeting tools and strategies that can be used by state and local WIC agencies. |
Closed – Implemented
USDA issued a first report in April 1988 and a final report for issuance in June 1990 to WIC and state agencies to provide technical assistance on how to target low-income pregnant women. USDA also developed and distributed a poster and a pamphlet providing information on WIC participation.
|
| Department of Agriculture | The Secretary of Agriculture should require FNS to seek the advice and assistance of experts in the field of nutrition and related health sciences in evaluating the role of dietary assessment in WIC, particularly as it relates to assessing nutritional risk, and work with those at the forefront of nutrition research to develop dietary screening and assessment techniques appropriate for use in the WIC certification process. |
Closed – Implemented
A panel of experts met in July 1989 to recommend what research should be done to find ways to help local agencies expedite the WIC certification process. The panel's report, with recommendations, was issued in January 1990.
|
| Department of Agriculture | The Secretary of Agriculture should require FNS to consult with medical authorities and competent professional bodies in and out of government, including such organizations as the World Health Organization, the Department of Health and Human Services, the American Academy of Pediatrics, and the American College of Obstetricians and Gynecologists, in developing uniform standards of risk for use in assessing those conditions, apart from dietary inadequacy, most commonly used to certify WIC applicants and recertify WIC participants. This should include, but not be limited to, standards for diagnosing such conditions as anemia, abnormal growth pattern, including obesity/underweight, chronic infections, adolescent pregnancy, smoking, and use of alcohol, caffeine, and other potentially harmful substances. |
Closed – Implemented
USDA has developed average standards of risk for use in assessing conditions for certifying WIC applicants and recertifying WIC participants.
|
| Department of Agriculture | The Secretary of Agriculture should require FNS to issue additional policy guidance on the need for full documentation of all nutritional risk conditions used as a basis for WIC certifications, where this would be feasible. FNS should routinely check the extent of such documentation as part of its evaluations of state and local WIC programs. |
Closed – Implemented
USDA has developed policy guidance that encourages states to document all nutritional risk conditions.
|
| Department of Agriculture | The Secretary of Agriculture should require FNS to promulgate regulations requiring documentation of the sources and amounts of WIC applicant-reported income and family size. Copies of applicant-provided income documentation, such as pay stubs, voluntarily provided tax records, and unemployment compensation checks, should be retained in each case file or, when this is not feasible, should be described in detail in the case file. To document family size, documents such as federal or state income tax returns, employee benefit policies, health or life insurance policies, court or church records, or, in the absence of these, applicant affidavits would seem acceptable. For applicants who could be accepted as income-eligible for WIC on the basis of reported participation in some other qualifying benefit program, evidence of current participation should be required. |
Closed – Implemented
USDA has initiated a 2-year study on income verification to be finished in late 1989. This study will establish an error rate to determine how states are administering the WIC program. USDA does not intend to promulate regulations.
|
| Department of Agriculture | The Secretary of Agriculture should require FNS to focus greater attention on the income eligibility determination component of the WIC certification process through specific coverage of this aspect during the management evaluations periodically conducted by FNS regional offices. In addition to assessing state agency policies and procedures in this area, the management evaluations should include the examination of a sample of local agency casefiles to test for compliance with federal and state requirements and to review the accuracy and reliability of income eligibility determinations. |
Closed – Implemented
FNS routinely monitored review records for income eligibility compliance and selected a sample of casefiles at the local level.
|
| Department of Agriculture | The Secretary of Agriculture should submit, for congressional consideration, proposed legislation to eliminate the existing statutory requirement that the Secretary reallocate WIC program funds periodically if it is determined that a state agency is unable to spend its allocation within a given program year. |
Closed – Implemented
USDA agreed with this recommendation, and included legal language in its fiscal year 1988 request, which satisfies this recommendation.
|
| Department of Agriculture | The Secretary of Agriculture should study the extent to which WIC state agencies should be permitted to carry over unexpended grant funds from one program year to the next, and propose legislation to authorize such carryover of funds as may be deemed appropriate. The proposed legislation should also authorize the Secretary to recover and reallocate WIC funds when projected underexpenditures exceed the allowable carryover, or in other circumstances where such action may be deemed appropriate. |
Closed – Implemented
USDA agreed with this recommendation. As a result, it included language in proposed legislation, which is included in P.L. 99-500, similar to this recommendation.
|
| Department of Agriculture | The Secretary of Agriculture should require FNS to require WIC state and local agencies to include in their monthly reports of participation data information showing the detailed categorical composition and priority risk composition of their participant case loads. |
Closed – Implemented
In June 1985, USDA issued regulations that require states to provide data on priority level and categorical participation. However, the reporting requirement is semiannual rather than monthly, as proposed by GAO.
|
| Department of Agriculture | The Secretary of Agriculture should require FNS to require WIC state agencies to routinely include information on the planned categorical and priority risk composition of participant case loads in expenditure plans submitted to FNS, and use these data, in combination with reported data on actual case load and priority risk composition, to negotiate workable targeting objectives with the states and monitor and assess states' targeting performance. |
Closed – Implemented
USDA complied with this recommendation by developing regulations addressing this issue, effective October 1, 1987.
|
| Department of Agriculture | The Secretary of Agriculture should require FNS to explicitly recognize WIC program targeting achievements, with proper notice and sufficient leadtime to states, in the assessment of state agency performance and decide on funding allocations that could lead to more effective resource management and provide tangible incentives for states to improve their targeting performance. |
Closed – Implemented
Funding regulations, addressing this recommendation, were effective October 1, 1987.
|
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Appropriation limitationsDisadvantaged personsEligibility criteriaEntitlement programsstate relationsFood relief programsHealth hazardsNutrition surveysProgram managementInfants