|DATE:||August 11, 2016|
|POLICY MEMO:||WIC Policy Memorandum #2016-4 Verification of Certification|
|SUBJECT:||WIC Policy Memorandum #2016-4 Verification of Certification|
Special Nutrition Programs
WIC State Agency Directors
This memorandum provides guidance for all state agencies administering the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) related to the issuance, acceptance, and confirmation of Verification of Certification (VOC) when a WIC participant moves from one service delivery area to another, particularly in the case of participants that move from one state to another. This memorandum supersedes WIC Policy Memorandum 93-7, WIC: Verification of Certification Cards. Food and Nutrition Service (FNS) Instruction 803-11, Revision 1, WIC Program – Certification: Verification of Certification (VOC) Cards, (December 2, 1988), remains in effect, pending revision to incorporate relevant updates.
The primary intent of the transfer/VOC provisions in the law and regulations is to ensure seamless and continued participation of certified participants through the entirety of their certification period. The provisions also aim to reduce the administrative burden on a certified participant, as well as local agencies. Protecting WIC program integrity is also an important consideration for the implementation of VOC policy.
Participants who arrive at a local agency or clinic (the receiving agency) with a valid VOC must be transferred and allowed to continue participating through the end of their current certification period, even if the participant does not meet the receiving agency’s nutritional risk, priority or income criteria, or the certification period extends beyond the receiving agency’s certification period for that category (e.g. six month versus one year child certification period). If a local agency is at maximum caseload, the transferring participant must be placed at the top of any waiting list and enrolled as soon as possible. Normal processing standards apply for all participants with a VOC.
- Name of participant.
- Date the certification was performed.
- Date income eligibility was determined: This may be different than the certification date.
- The nutritional risk of the participant: In an effort to make the transfer as seamless as possible, the sending agency should always clearly write out the specific nutritional risk. Clinics should not use codes or descriptions that make it difficult for the receiving agency to easily identify the nutritional risk of the participant.
- Date the certification expires.
- The signature and printed name of the certifying local agency official. This does not have to be the person that originally certified the participant. It can be the local agency staff person that provides the VOC, when requested.
- The name, address and phone number of the certifying local agency. A phone number will help the receiving agency make contact if there are questions or if additional information needed.
- An identification number (which may be the WIC participant ID number) or other form of VOC accountability.
In an effort to preserve the integrity of the program, the sending agency is encouraged to indicate the last date benefits were issued. VOC information can be handwritten if the current management information system or form does not currently include certain information. This information will further facilitate the seamless transfer of benefits by helping the receiving agency determine the amount of benefits to issue once a participant arrives in the new location. Receiving agencies are encouraged to contact the sending agency to verify any questionable information contained on the VOC.
Participants who are eligible to receive WIC formula (infant formula, exempt infant formula, or WIC-eligible nutritionals) in Food Package III must have one or more qualifying conditions, as determined by a health care professional licensed to write medical prescriptions under state law. Providing a copy of this documentation to the participant can streamline the transfer benefits for the participant.
Occasionally, a transferring participant will present a VOC to a receiving agency that is missing one or more of the required components. The transferring participant must not be penalized, nor services delayed for the failure of a sending agency to properly include required components. Therefore, a VOC must be considered valid if it contains the following three items: 1) the participant’s name; 2) the date of certification; and 3) the date that the current certification period expires. Transferring participants who present a VOC with at least these three pieces of information must be treated as if the VOC
contains all of the required information. If a nutritional risk is not recorded on the VOC or if the participant was certified based on a nutrition risk condition not in use by the receiving agency, the receiving agency must use risk code 502 (or the state agency equivalent code) “Transfer of Certification” to establish nutritional risk for that participant.
WIC state agencies should review their VOC procedures and format to ensure that only necessary information is provided and is easily identified on the VOC. As new information systems are developed, state agencies should ensure that the VOC process and printouts are designed to ensure the appropriate information is provided in a clear and concise format.
This point of contact, at a minimum, must be a phone number that is monitored during the normal daily operating hours of that state agency. This number can be an existing number, such as a general information number. However, staff assigned to monitor this phone line must have the ability to retrieve VOC information and provide the information to the requesting WIC staff. If the state agency is not able to access participant certification information stored in a local or state agency data system, the state agency must have procedures for requesting and receiving the necessary information and providing it to the receiving agency no later than the next business day.
FNS will update the state agency listing on the public website with VOC points of contact: http://www.fns.usda.gov/wic/wic-contacts. Any change to this information must be reported to FNS within three business days of the change.
State or local agencies must not routinely require participants to sign a release of information to share VOC information with other state or local WIC agencies. Information collected by WIC about a participant is considered confidential, and except as otherwise permitted by regulation, may only be used for WIC purposes. Confidential information may be disclosed to persons directly connected with the administration or enforcement of the WIC program for program purposes (7 CFR 246.26(d)(1)(ii)). This means that a sending agency may share information about a transferring participant with a receiving agency, without prior consent or written release by the participant.
Finally, the requirements of the Health Insurance Portability and Accountability Act of 1996 (HIPAA, P.L.104-191 ) do not apply to the information collected by the WIC program for program purposes (WIC Policy Memorandum 2002-2: Department of Health and Human Services’ Regulations to Implement the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and Applicability to the WIC Program). In those instances where WIC services are provided by an entity that is otherwise subject to the HIPAA requirements, state and local agencies should avoid comingling WIC information and HIPAA protected information, such that HIPAA protected health information should not be included on the VOC.
The receiving agency must destroy the unused food instruments or EBT card from the transferring participant.
If the participant has unredeemed benefits from the current benefit period, the receiving agency should, to the extent practicable, provide a food package that ensures the participant receives the maximum monthly allowance for that month, unless individually tailored in accordance with 7 CFR 246.10. For state agencies that use a calendar month food package issuance, the food package must be prorated based on the amount of benefits already redeemed. This information should be retrieved from the sending agency.
Supplemental Food Programs Division
The contents of this guidance document do not have the force and effect of law and are not meant to bind the public in any way. This document is intended only to provide clarity to the public regarding existing requirements under the law or agency policies.