The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides nutritious foods, nutrition education, breastfeeding support, and referrals to health care and social services to pregnant and postpartum people with low incomes, infants, and children under age 5. Despite the well-documented benefits associated with WIC participation,[2] in recent years almost half (46.5 percent in 2022) of eligible people have not been enrolled, especially pregnant individuals and children aged 1 through 4.[3] To reach more eligible families with low incomes, state and local WIC agencies have adjusted their policies and practices to remove barriers to enrollment; these efforts were accelerated under COVID-19-related waivers of certain program rules and continued with waivers authorized by the 2021 American Rescue Plan Act (ARPA).[4] In 2023 the U.S. Department of Agriculture (USDA), which administers WIC, issued a policy memorandum to clarify available flexibilities for streamlining WIC certification and to encourage WIC state agencies to adopt them.[5]
This report compiles selected state WIC certification policies that CBPP collected from WIC state agencies during the summers of 2021 and 2022 and updated in the fall and winter of 2023-2024. Understanding which policies states have implemented can help federal policymakers update program rules — legislatively when WIC is reauthorized, or administratively — and assist state program administrators with implementing policies that simplify WIC enrollment and recertification procedures. Such simplifications make it easier for eligible families to get and stay enrolled and reduce the administrative burden on local staff. WIC state agencies can use this information to identify policies they might wish to adopt and connect with states that have implemented them.[6]
Many state agencies have implemented one or more policies that USDA’s 2023 policy memo on streamlining certification highlighted as available flexibilities to reduce barriers to participation.
- Thirty-five WIC state agencies report having a policy allowing income and/or residence eligibility to be determined in advance of certification appointments; one additional state reports that it is in the process of implementing this policy. Checking income and residence eligibility in advance reduces both the duration of the certification appointment and the number of documents that applicants must provide.
- All but five WIC state agencies permit applicants to provide electronic documentation, either in person or transmitted by secure electronic methods, though the number and types of methods available for sharing documents vary widely.
- Forty WIC state agencies facilitate prompt enrollment of newborns by using the mother’s (or another household member’s) participation in Medicaid, the Supplemental Nutrition Assistance Program (SNAP), and/or Temporary Assistance for Needy Families (TANF) as the basis for eligibility; two additional states are in the process of implementing this policy. However, ten of these states do not include participation in SNAP, as permitted by USDA.
- Forty-five WIC state agencies accept documentation of a WIC applicant’s enrollment in Medicaid, SNAP, or TANF to document their residence and/or identity as well as their income; one additional state is implementing this policy.
- Forty-two WIC state agencies allow temporary 30-day certifications to give applicants more time to provide eligibility documents without delaying food benefits.
By adopting more of these flexibilities, WIC state agencies can build on the small but statistically significant increase in WIC coverage between 2021, when 51.3 percent of eligible people participated, and 2022, when the share rose to 53.5 percent.
In addition to the policy flexibilities described in the USDA memo, there are long-standing policies that allow state agencies to reduce certification barriers or expedite enrollment.
- Twenty-nine WIC state agencies allow for presumptive eligibility in advance of the nutrition assessment, so pregnant applicants can begin receiving food benefits as soon as they are determined to be income-eligible.
- Forty WIC state agencies have eliminated the requirement that households without any income provide a third-party statement verifying their income, which can prevent or delay vulnerable families from obtaining nutrition assistance during critical periods of prenatal, infant, and child development.
- Thirty-four WIC state agencies exempt infants and children of working parents from being physically present for certification appointments. While many states currently have a waiver permitting certification to be done by telephone or videoconference for all applicants, those that adopt the flexibility to exempt infants and children of working parents can reduce the burden of certification appointments when waivers end.All the policies described in this report are allowed under regular program rules, will remain available to states after the ARPA-related waivers expire, and can be adopted by states by amending their state plan, revising their policy manual, or both. More widespread adoption of all these policies would allow eligible individuals to receive benefits more easily and promptly, which could increase WIC enrollment and improve health outcomes. In addition, adopting these policies could reduce the administrative burden of certifying eligible individuals, which would free up appointment time for nutrition services and could help local agencies with staffing challenges.
Assessing Your WIC Certification Practices
A toolkit to help WIC agencies modernize and streamline the certification process is available at www.cbpp.org/wiccertificationtoolkit. The toolkit includes descriptions of practices for facilitating WIC enrollment and simplifying eligibility determinations, along with examples from WIC state and local agencies and additional resources.
Report Presents Updated Certification Policies and Practices
Eligibility for WIC benefits is assessed when applicants first apply and periodically thereafter. The program serves certain categories of applicants: infants and children under age 5, pregnant individuals, and postpartum individuals for up to one year. Additional WIC eligibility criteria include income, residence, and nutritional risk. Applicants are also required to provide identification. Eligible applicants are certified for up to one year.
While WIC programs operate under certain federal eligibility rules and policies, state and local WIC agencies have considerable flexibility to determine how they certify new applicants and recertify participants. WIC state agencies set policies and procedures for certifying eligibility, and local agencies or clinics implement these within the context of their staffing patterns and facilities. As a result, WIC agencies employ a wide range of certification options and a variety of processes.
During 2016, CBPP collected information about selected certification policies and practices for a report published in January 2017.[7] Since then, many state and local WIC agencies have changed their certification processes. Moreover, the COVID-19 pandemic required agencies to adopt new ways of certifying and serving participants. Increased use of technology and experience with remote appointments have increased flexibility and simplified certification processes while inspiring creative ways of gathering information.
As a result, many promising practices are emerging. Practices such as online applications and electronic referrals from health care providers streamline WIC enrollment, which helps both participants and staff. Increased coordination with health care providers reduces the need for families to provide duplicative information and for WIC staff to collect measurements and bloodwork, which contributes to streamlining the certification process and enhancing continuity of care.
To document some of the changes, CBPP has periodically asked the 50 geographic WIC state agencies to update the information about certification policies and practices published in the 2017 report and to respond to questions about additional items. The District of Columbia was also asked to provide the information starting in 2022. While other U.S. Territories and tribal organizations serve as state agencies operating the WIC program, their policies are not included in this report. The geographic state agencies serve the vast majority of WIC participants (98 percent in fiscal year 2023).
Nearly all states responded to requests for updates in 2021 and 2022 (47 of 50 in 2021 and 48 of 51 in 2022), and most (41 of 51) also provided updates in 2023-2024. This report summarizes the information they provided in three sections, each with a table of policies and practices across the state agencies. The range of certification processes listed here can be used as resources for federal stakeholders to understand their use and for state program administrators to connect with their peers to learn about different approaches.
Adjunctive Eligibility Simplifies Enrollment
To help ensure that low-income families with young children receive the full array of benefits and supports for which they are eligible, and to avoid duplicative administrative work, policymakers have streamlined enrollment across benefit programs through a policy known as adjunctive eligibility. Under federal law, applicants who are enrolled in Medicaid or SNAP or receive monthly TANF cash assistance payments meet WIC’s income requirement.[8] This long-standing policy simplifies WIC eligibility determinations for more than 3 in 4 applicants.[9] Nonetheless, 53 percent of WIC-eligible SNAP enrollees and 61 percent of WIC-eligible Medicaid enrollees did not participate in WIC in 2022.[10] Targeted outreach to these groups and robust referrals from health care providers are important ways of increasing WIC take-up.[11]
During the certification process, WIC agencies must first attempt to determine if the applicant is adjunctively income-eligible before performing a traditional income determination. State agencies must include procedures in their annual state plan for obtaining adjunctive eligibility information prior to the certification appointment.[12] While nearly all states accept an applicant’s paper documentation of Medicaid, SNAP, or TANF participation, such as an eligibility determination letter, they also use a variety of other options to check for participation. All WIC agencies have access to online portals, data, or automated phone systems set up by at least one of the other programs; 15 agencies have integrated a process to check for adjunctive eligibility into the WIC information system and three more are developing an integrated process. (See Table 1.)
USDA highlighted in its 2023 policy memo on streamlining certification that infants of participants who are enrolled in Medicaid and received WIC while pregnant are income-eligible for WIC. USDA encouraged state agencies to implement this policy to facilitate timely WIC enrollment of newborns. Forty states have already implemented this policy and two others are in the process of implementing it.[13] While most (37) of these states certify income-eligibility for infants of participants enrolled in Medicaid, fewer states (30) report permitting it for infants born into families enrolled in SNAP. (See Table 3.) Since the USDA memo clarifies that infants in families receiving SNAP or TANF are income-eligible, by adding this to their income eligibility policies states can facilitate timely enrollment of infants in families participating in SNAP or TANF but not Medicaid.
Nearly all WIC state agencies accept documentation of enrollment in Medicaid, SNAP, or TANF to document both income and residence if that program checks residence within the state as part of its eligibility process. Enrollment in these programs is also used to document identification in most states, which maximizes the benefit of checking for adjunctive eligibility. USDA encourages state agencies to permit one source to document multiple eligibility factors to make the process easier for both participants and staff.
Table 1 shows how state agencies direct local staff to check for adjunctive eligibility. It also includes state policies for using adjunctive eligibility documentation to document residence and/or identity in addition to income.