By: Hope A. Lane-Gavin, Fellow, Health Equity, The Center for Community SolutionsKatherine Ungar, Policy Associate, Children’s Defense Fund – Ohio
The American Rescue Plan Act (ARPA) of 2021 has been at the top of hearts and minds since its passage last year as state and local governments prioritize economic recovery following the height of the COVID-19 pandemic. ARPA funds have been used for a myriad of projects on every level of government, from statewide grants to law enforcement for crime reduction, to local home repair programs, and everything in between.
As part of these efforts to strengthen our public health infrastructure and close health disparities that the pandemic exposed and widened, ARPA also made significant investments in health and human service programming. This included aid to time-sensitive temporary programming such as increased testing and vaccine manufacturing and production and enhanced food allotments. The legislation also included policy change in proven, long-standing programs such as increased postpartum insurance coverage for birthing people on the Medicaid program, and most relevant to this blog, dedicated funding in the amount of $900 million for the Special Supplemental Nutrition Program for Women, Infants and Children (WIC).
The USDA, which administers the WIC program federally, released an additional $490 million to bolster the program shortly after ARPA was signed.
Some reform universal, others left to states
The United States Department of Agriculture (USDA), which administers the WIC program federally, released an additional $490 million to bolster the program shortly after ARPA was signed. This allowed for the boosting of the WIC cash-value voucher benefit from $9 per child and $11 per pregnant, postpartum or breastfeeding woman up to $35 per child and adult for up to four months. While this was an opt-in benefit for state agencies, every WIC agency in the country participated and thus every WIC family, in theory, had access to increased monthly benefits.
Following the expiration of the enhanced benefits and a report finding the WIC benefit bump resulted in increased fruit and vegetable consumption among WIC-enrolled children, Congress extended, increased and made mandatory the bump through the fiscal year 2022 appropriations process. As of this writing, children (ages 1-5) receiving WIC will get $24 each month; pregnant, postpartum and some breastfeeding women will get $43 each month; and fully and partially breastfeeding women will get $47 each month as recommended by the National Academies of Science, Engineering and Medicine through the end of the federal fiscal year (September 30, 2022).
As of this writing, children (ages 1-5) receiving WIC will get $24 each month.
Additional ARPA funding allocated to the WIC program will be distributed through USDA’s Food and Nutrition Service (FNS) non-competitive grant process and obligated to WIC state agencies. These funds, $390 million in total, are to be used to carry out outreach, innovation, and program modernization efforts to increase participation and redemption of benefits in the WIC program. A couple of funding opportunities have been announced already including the first $15 million of $50 million dedicated to specifically improve the shopping experience, and more funding opportunities are expected. Opportunities for these funds include, but are not limited to, hiring project management and support staff to initiate WIC shopping reform strategies or helping put existing strategies into action.
OhioWIC beneficiaries and staff say shopping reform is overdue
In our previous blogs, we have highlighted how OhioWIC and its enrollment and retention has suffered immensely over the last several years due to an offline system that makes for an overly complicated shopping and certification experience. In fact, because OhioWIC is offline, beneficiaries initially had to make an extra trip to their local WIC clinic to have the additional fruit and vegetable monies loaded onto their Electronic Benefit Transfer (EBT) card. This means that in Ohio and other offline states, if beneficiaries were unaware of the increase due to lack of communication from their state or county agency or were unable to get transportation to their physical clinic location, they missed out on the additional benefit, despite being eligible for it.
And because OhioWIC is offline, shopping innovations that online states are recommended to test with modernization funds such as online shopping, curb-side pickup and grocery delivery is wishful thinking, despite shopping experience being a well-documented pain point for OhioWIC participants.
For this reason, we strongly recommend that the Ohio Department of Health (ODH) apply for year 1 funding by August 8, 2022, to bring Ohio’s WIC program into the 21st century.
We strongly recommend that the Ohio Department of Health (ODH) apply for year 1 funding by August 8, 2022, to bring Ohio’s WIC program into the 21st century.
Ohio should apply for recent USDA-FNS Grant
USDA FNS also announced a WIC Shopping Experience Improvement Grant last month to test and launch online shopping for WIC participants. Through this grant, FNS has declared it will fund projects where the primary goal is to “improve the shopping experience, as evidenced by increasing the redemption of WIC benefits, improving customer satisfaction, and/or improving participant access to vendors, including for underserved communities and individuals.” Through conversations with WIC participants and local WIC Directors, there are many improvements that can and should be made through this grant funding.
Online shopping can help level the playing field
The ongoing infant formula crisis reveals the need to expand WIC to online shopping. As we discussed here, the infant formula shortage had a disproportionate impact on WIC participants who were not only required to shop in store but were also limited to specific brand and can sizes when purchasing their formula. Middle- and upper-class families were able to scour the internet to find formula, a luxury not afforded to WIC users due to the prescriptive nature and the lack of online shopping. But even prior to the pandemic, lack of online shopping negatively affected those using WIC. While most people were able to order their groceries online for pick-up or even delivery, WIC participants had to shop in store (and in some cases, unable to make use of self-checkout) to utilize their benefits.
Technological improvements can make WIC more accessible and user friendly
In addition, these grant funds could help improve technological aspects of OhioWIC. First, we have discussed the need to implement an online system and join the 41 other states who are able to electronically transfer benefits to participants’ EBT cards without requiring them to physically come into the office. Second, there must be significant technological updates so that WIC participants are able to check their food benefit balance and accurately rely on that balance. WIC participants shared that they experience delays in WIC benefit balances (sometimes up to several days) while using the WIC Shoppers Application, the only other way they can check besides hanging on to physical receipts. ODH should also set up a toll-free number for participants to call and determine their benefit balance. Third, all WIC offices should have the capability to send text message communications with their participants. Many WIC participants who receive benefits from a location that is able to send messages noted that these communications were helpful in alerting them to farmer’s markets where they could utilize their benefits and get coupons and also when there were changes to the benefit amount (i.e., the fruit and vegetable increases). While some OhioWIC projects can send messages, many cannot. This is an important outreach strategy that should be available to all offices.
Creation of a Statewide Advisory Council provides an opportunity to learn from WIC participants, local directors, retailers, and advocates to ensure that Ohio makes smart decisions and investments to improve the program
Finally, we recommend that ODH form a statewide WIC Advisory Council to help inform improvements to the WIC program. The advisory council must include WIC participants who have lived expertise in navigating the WIC program, local WIC directors, WIC retailers, and advocates. An advisory council will not only help Ohio to better identify the challenges and opportunities that exist to improve user experience but may also result in innovative ideas and pilots that could transform WIC.
We are grateful for the ongoing commitment and attention to the WIC program at the federal level and are hopeful that Ohio will seize these opportunities to better serve Ohio’s WIC participants.
Opportunities and Recommendations
The Ohio Department of Health should take full advantage of the funding opportunities presented to by USDA FNS to improve OhioWIC. Although the WIC program has been proven to be a cost-effective investment that safeguards the health and well-being of low-income families at risk for poor health outcomes, too many Ohio families who qualify for WIC, are unable to access and utilize the program. OhioWIC has a unique opportunity to timely transform the way WIC works in our state, as opposed to doing so in a piecemeal fashion, by focusing on innovations in:
- Remote benefit loading
- Technological improvements
- Online shopping, grocery delivery and pick-up
- Statewide advisory councilWe are grateful for the ongoing commitment and attention to the WIC program at the federal level and are hopeful that Ohio will seize these opportunities to better serve Ohio’s WIC participants.