Appendix L: WIC Policy Memo

Appendix L - WPM-2023-5.pdf

Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Program Regulations - Reporting and Recordkeeping Burden

Appendix L: WIC Policy Memo

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Appendix L
WIC Policy Memorandum #2023-5:
Data Sharing to Improve Outreach and
Streamline Certification in the Special Supplemental Nutrition
Program for
Women, Infants, and Children (WIC) Income Eligibility
Guidelines

Food and
Nutrition
Service
1320
Braddock
Place
Alexandria,
VA
22314

April 25, 2023
SUBJECT:

WIC Policy Memorandum #2023-5: Data Sharing to Improve Outreach and
Streamline Certification in the Special Supplemental Nutrition Program for
Women, Infants, and Children (WIC)

TO:

Regional Directors
Special Nutrition Programs
WIC State Agency Directors
All State Agencies

Introduction
This policy memorandum provides guidance on data sharing activities that support targeted
outreach and streamlined certification processes aimed at increasing the Special Supplemental
Nutrition Program for Women, Infants, and Children (WIC) participation and retention. It
expresses the U.S. Department of Agriculture’s (USDA) Food and Nutrition Service’s (FNS)
support of data sharing, provides an overview of data sharing relevant to WIC, summarizes WIC
Program guidance on sharing confidential WIC participant data, and lays the groundwork for
future guidance and resources to help WIC State agencies expand outreach and streamline the
certification process.
In March 2021, the American Rescue Plan Act of 2021 (ARPA, Pub. L. 117-2) provided the USDA
with funds to carry out outreach, innovation, and program modernization efforts to increase
participation and redemption of benefits in the WIC Program (for more information, see WIC
and WIC FMNP Informational Memorandum: American Rescue Plan Act of 2021 (Pub. L. 117-2),
Program Modernization (FNS-GD-2021-0023)). As part of these efforts, which have been
informed by input from diverse program stakeholders, the FNS is working to advance data
sharing at the State and local agency levels.
FNS supports WIC State and local agency data sharing efforts that aim to increase program
enrollment and retention. FNS is committed to developing tools and resources, facilitating
information sharing, and providing technical assistance and funding opportunities to assist in
establishing, maintaining, and improving data sharing activities. Likewise, FNS encourages WIC
State agencies to allocate resources to data sharing efforts that allow WIC-eligible individuals to
access Program benefits and services in a straightforward and timely manner.

Regional and WIC Agency Directors
Page 2

Data Sharing Overview
Data sharing involves the secure and confidential exchange of pertinent information about an
individual between a WIC and non-WIC entity, with the intent of streamlining access to
Program benefits by eligible individuals.
WIC State and local agencies may engage in data sharing, with appropriate agreements and
consent(s) between various programs and entities, including but not limited to, the
Supplemental Nutrition Assistance Program (SNAP), Medicaid, Temporary Assistance for Needy
Families (TANF), programs conferring automatic income eligibility, healthcare providers, or
healthcare information exchange networks. State SNAP and Medicaid agencies can engage in
data-sharing with WIC in accordance with their respective legal authorities, at Section 11(e)(8)
of the Food and Nutrition Act and Section 1902(a)(7) of the Social Security Act, with
implementing regulations at 42 CFR part 431, subpart F, respectively.
Section 17(f)(22) of the Child Nutrition Act (Pub. L. 89-642) and Sections 1902(a)(11)(C) and
1902(a)(53) of the Social Security Act require the coordination of efforts between WIC State
agencies and state Medicaid programs. These requirements are further specified in Medicaid
regulations at 42 CFR §431.635 (c). WIC State agencies should continue and/or renew
collaboration with their state Medicaid counterparts to ensure services are coordinated.
FNS encourages WIC State and local agencies to consider ways to streamline WIC certification
and should explore ways to develop, update, and utilize data sharing agreements, including:
1) Facilitate Targeted Outreach: Identify and conduct targeted outreach to income-eligible
individuals using participation data sourced from adjunctive and/or automatic income
eligibility programs. This process is also referred to as data matching or in-reach. For
example, with an agreement in place, WIC and SNAP could match data for all children
under five actively participating over the previous three months. Once the data has
been matched, children who are enrolled on SNAP but not on WIC could be identified
for outreach activities by the WIC Program. Data obtained for matching may include, but
is not limited to, an individual’s name(s), date of birth, phone number(s), address(es),
and/or language preference for best results.
• Programs that confer adjunctive income eligibility include SNAP, Medicaid1, and
TANF.2
• Programs that confer automatic income eligibility are state-administered
programs designated by the WIC State agency that routinely require
documentation of income and have income eligibility guidelines at or below the
State agency’s WIC Program income guidelines.3
1

See 7 CFR 246.7(d)(2)(vi)(A) stating that Medicaid refers solely to the medical assistance program
established under Title XIX of the Social Security Act.
2
7 CFR 246.7(d)(2)(vi)(A)
3
7 CFR 246.7(d)(2)(vi)(B)
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Regional and WIC Agency Directors
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2) Leverage Adjunctive and Automatic Eligibility: Use data available from applicable
programs to determine adjunctive or automatic eligibility in preparation for or during
certification and/or recertification to reduce the burden on applicants and participants
to provide this information.
3) Simplify Collection of Certification Documentation: Streamline the document collection
process for certification, including proof of identity, residency, automatic/adjunct
eligibility (see above), income, and/or referral data, from available sources to reduce
participant burden.
4) Streamline Collection of Nutritional Risk Data: Source additional nutrition risk data, such
as anthropometric measurements (height and weight or length) and bloodwork
(hematological test for anemia) from external programs or entities (e.g., healthcare
providers or information exchanges) to increase the efficiency of the enrollment and
nutrition assessment processes and reduce participant burden. In addition to the
required data, WIC State agencies may allow external sourcing of other medical data
relevant to the nutrition assessment process, such as past or current diagnoses,
medication records, or test results.
5) Include WIC in Adjunct Program Applications: Develop joint applications for adjunctive
programs that include WIC as an option. For instance, if Medicaid, SNAP, and TANF have
a joint application, WIC criteria may be added to the application. For such joint
applications with Medicaid, there are some restrictions. First, any joint applications
must be reviewed and approved by the Secretary of HHS. See 42 CFR 435.907(b)(2).
Second, to the extent that such information is not also needed for a Medicaid eligibility
determination, such information must be optional and clearly differentiated from
Medicaid criteria. See 42 CFR 435.907(e)(1). Data from such applications relevant to WIC
can be routed to WIC for completion of certification and enrollment.

This is not an exhaustive list of data sharing or certification streamlining initiatives State
agencies may wish to pursue. Local agencies should coordinate with their State agency
regarding any planned data sharing initiatives to ensure that all WIC Program requirements are
met. WIC State agencies should reach out to their respective FNS Regional Office with any
questions or needs for technical assistance.
Medicaid Program Requirements for Data Sharing and Confidentiality
Medicaid state agencies must restrict the use or disclosure of information concerning Medicaid
applicants and beneficiaries to purposes directly connected with the administration of
the State Plan under section 1902(a)(7) of the Act and implementing regulations at 42 CFR part
431, subpart F. Sharing data with a WIC State or local agency in order to facilitate or modernize
coordination efforts required under Sections 1902(a)(11)(C) and 1902(a)(53) of the Social
Security Act, is a purpose directly related to the administration of the State Plan.

USDA is an Equal Opportunity Provider, Employer and Lender

Regional and WIC Agency Directors
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Any release of information from the State Medicaid agency to the WIC State agency must
comply with all Medicaid confidentiality requirements at 42 CFR § 431.306, including but not
limited to:
• Access to information concerning applicants or beneficiaries must be restricted to
persons or agency representatives who are subject to standards of confidentiality that
are comparable to those of the Medicaid agency (42 CFR § 431.306(b)); and
• Permission must be obtained from the Medicaid applicant or beneficiary before the
agency releases information to an outside source (42 CFR § 431.306(d)). This consent
could be obtained by either agency (e.g., on the Medicaid application, during the WIC
interview, or at another time period).
WIC Program Requirements for Data Sharing and Confidentiality
Overview
Per WIC regulations, confidential information refers to any information that individually
identifies an applicant or participant and/or family member(s).4 While this type of data must be
kept confidential, it may be shared in some circumstances, including to assist with certifying or
recertifying people in the Program. This section summarizes relevant key requirements in WIC
regulations and guidance pertaining to the use and disclosure of confidential WIC applicant and
participant information so far as they relate to data sharing, including those requirements in
WIC regulations at 246.26(d), 246.26(h), and 246.26(i); FNS Instruction 800-1; and the
requirements from Policy Memorandum #2002-2 summarized below:
Notably, the Health Insurance Portability and Accountability Act of 1996 (HIPAA; Pub. L. 104191) does not apply to WIC. WIC State agencies are not authorized to use WIC funds to pay any
costs to make a data system HIPAA compliant. However, if a WIC State agency is seeking data
from a program that must comply with HIPAA, then WIC State agencies are authorized to use
WIC funds to develop a crosswalk or interface to access/read such HIPAA-compliant data (for
more information, see Policy Memorandum #2002-2). FNS supports State agencies in
developing such crosswalks or interfaces and encourages State agencies to consult with their
Regional Office on opportunities and allowable uses of federal funds prior to beginning
projects.
The WIC Program requirements do not apply when WIC agencies only receive data from other
programs or entities and no data originating from the WIC Program are being shared. Likewise,
this section does not cover rules governing data sharing for other programs or entities. WIC
State agencies must identify and uphold the requirements for using confidential information
4

7 CFR 246.26(d)(1)(i)
USDA is an Equal Opportunity Provider, Employer and Lender

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from a source external to WIC. Requirements may vary by jurisdiction, and FNS encourages WIC
State agencies to work with their appropriate legal counsel to ensure all requirements are met.
The following are the different requirements for sharing data for WIC and non-WIC purposes.
Sharing Data for WIC Purposes5
FNS does not require confidentiality agreements or participant release forms when data sharing
is for WIC purposes. WIC staff may disclose confidential information to people directly
connected with the administration or enforcement of the WIC Program whom the State agency
determine have a need to know the information for WIC Program purposes, including but not
limited to:
• Personnel from the WIC State and local agencies and other State or local agencies (note:
such personnel must have ongoing involvement in the operation or management of the
WIC Program);
• Persons under contract with the State agency to perform research regarding WIC; and
• Persons investigating or prosecuting WIC Program violations under Federal, State, or
local law.
Examples of data sharing for WIC purposes include sharing participant data to provide a
Verification of Certification and monitoring dual participation.
Sharing Data for Non-WIC Purposes6
WIC State or local agencies may also use or share confidential applicant and participant
information for use in the administration of programs that serve persons eligible for WIC,
including other programs administered by the health department and by public organizations.
For instance, in addition to the adjunctive and automatic eligibility programs previously
described programs such as Head Start and Early Head Start, Immunizations, and the Child and
Adult Care Food Program (CACFP) are often administered by the state health department or
other public organization and may be considered for such data sharing initiatives. This is
considered data sharing for non-WIC purposes. The following requirements apply to sharing
WIC applicant and participant data for non-WIC purposes:
The recipient organization may only use such data for the following purposes: 7
1. Determine the eligibility of WIC applicants and participants for programs administered by
such organizations;
2. Conduct outreach for such programs;
5

7 CFR 246.26(d)(1)
7 CFR 246.26(d)(2)
7
7 CFR 246.7(i)(11)
6

USDA is an Equal Opportunity Provider, Employer and Lender

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3. Enhance the health, education, or well-being of WIC applicants and participants currently
enrolled in those programs;
4. Streamline administrative procedures to minimize burdens on participants and staff; and,
5. Assess and evaluate a State's health system in terms of responsiveness to participants'
health care needs and health care outcomes.
The WIC State or local agency must take the following steps before using or disclosing
confidential applicant or participant information for non-WIC purposes:8
1. The state’s chief health officer (or, in the case of an Indian Tribal Organization (ITO), the
governing authority) must designate in writing the permitted non-WIC use of the
information, and the names of the organizations to which such information may be
disclosed.
2. The applicant or participant must be notified either at the time of application or through a
subsequent notice that the State agency may disclose information about their participation
in the WIC Program for non-WIC purposes.
3. The State or local agency disclosing the information must enter into a written agreement
with the other organization or, in the case of a non-WIC use by a State or local WIC agency,
the unit of the State or local agency that will be using the information.
a. Written agreements must (i) specify that the use or disclosure of WIC participant
and applicant information will be limited to the five purposes allowed by WIC
regulations (see above) and (ii) contain the receiving organization's assurance that it
will not use the information for any other purpose or disclose the information to a
third party.
b. WIC State and local agencies may disclose confidential information to individuals or
entities when there is not a written agreement in place if the affected applicant or
participant signs a release form authorizing the disclosure and specifying the parties
to which the information may be disclosed.
i. Applicants and participants must be allowed to refuse to sign the release
form and must be made aware that signing the form is not a condition of
eligibility, nor will refusing to sign the form affect their participation in WIC.
ii. Release forms authorizing disclosure to private physicians or other health
care providers may be included as part of the WIC application or certification
process. All other requests for applicants or participants to sign voluntary
release forms must occur after completing the application and certification
process.
4. The State agency must include in its State Plan a list of all organizations with which the State
agency or its local agencies has executed, or intends to execute, a written agreement.

8

7 CFR 246.26(h)(2)
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Forthcoming Resources
FNS recognizes WIC State and local agencies may face barriers in initiating and maintaining data
sharing efforts and seeks to further understand and help agencies overcome these challenges.
We further recognize WIC agencies have varying types and degrees of data sharing activities
underway and therefore have diverse needs for support.
FNS is committed to sharing information and resources, facilitating State and local agency
sharing of best practices and lessons learned from existing data sharing initiatives, and offering
funding opportunities to help WIC agencies start or expand efforts in this area. FNS is also
collaborating with federal partners to promote and support data sharing across programs.
FNS encourages WIC State agencies to regularly communicate with their respective Regional
Office regarding question, including to share any needs, and/or updates related to data sharing
activities. We look forward to working together to advance data sharing toward better reaching
and serving more WIC-eligible families.

SARA OLSON
Director
Policy Division
Supplemental Nutrition and Safety Programs

USDA is an Equal Opportunity Provider, Employer and Lender


File Typeapplication/pdf
File TitleWIC Policy Memorandum #2023-5: Data Sharing to Improve Outreach and
SubjectSara Olson, Policy Director, SNAS
AuthorYoast, Katey - FNS
File Modified2023-07-24
File Created2023-04-26

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