USDA FUNDING BASED ON: Estimated # of Eligible WIC Clients And - PDF document

WIC Food Package 2019/20 1 USDA FUNDING BASED ON:  Estimated # of Eligible WIC Clients  And Actual # of WIC Clients Served  USDA NSA (NUTRITION SERVICES Administration) & FOOD COSTS are Separate.  MI CANNOT use Food $ for Administration 2 2018 1

WIC Food Package MI Funding & Caseload  NSA GRANT FY 2019 : $67.2 million  Food GRANT FY 2019 : $101.6 million  ~$5.7 billion in 2019 for WIC Nationwide  4/2018 MI MONTHLY CASELOAD: 212,484  7/2019 MI MONTHLY CASELOAD: 161,654 3 COST CONTAINMENT Cost containment contracts with infant formula companies are required by federal WIC Regulations DISCOUNTS/REBATES on infant formula as a result of competitive bidding process. 4 2018 2

WIC Food Package ~1447 WIC Authorized Vendors Statewide  1196 Grocery Stores  251 Pharmacy Only  Each Store MUST have Minimum Stock Requirements  MUST participate in SNAP 5 6 2018 3

WIC Food Package How does WIC choose Food Packages? NAM (National Academy of Medicine) recommended: (Formerly known as the Institute of Medicine (IOM) 2015) • Breastfeeding • Fruits & vegetables • Whole grains • Reduce saturated fat for ages 2 years & older 7 How does WIC choose Food Packages? cont… • Developmental Needs of infants & children • Obesity • Flexibility for WIC state agencies • Variety for WIC clients 8 2018 4

WIC Food Package Maximum Allowable Food Package Clients must receive the maximum allowance of food items unless food package needs to be customized. Customizing : When it is medically or nutritionally warranted (e.g., to eliminate a food due to a food allergy) • If client refuses or cannot use the maximum monthly allowances; or when the quantities necessary to supplement another program’s contribution to fill a medical prescription would be less than the maximum monthly allowances. 9 10 2018 5

WIC Food Package JUICE: Nutrition Fact Label Changes • WIC’s previous minimum juice nutritional requirement was: 100% juice 120% daily value Vitamin C • New FDA rule Vitamin C : has increased from 60 to 72 mg • As a result, 100 % juice will now only meet 80% DV Vit‐C This Photo by Unknown Author is licensed under CC BY- 11 NC-ND Yogurt: C2‐C4 & Women May receive 32 oz. of low fat or non‐fat yogurt 32 oz. Yogurt replaces One Quart of milk (32 oz.) NO YOGURT in whole or 2% Milk Packages 2018 6

WIC Food Package Children Receive: • Milk, cheese, eggs, peanut butter/beans, 36 oz. of cereal & juice in 64 oz. containers • Fresh fruits & vegetables, whole grains • Ages 1 to 2 years: WHOLE MILK (no yogurt allowed due to poor availability) • Ages 2 – 4 years: skim (fat free), ½% or 1% milk* * ( 32 oz yogurt = 1 quart of low fat milk ) 13 Standard Food Packages for Children Food Package C1 C2-C4 Juice 2- 64 ounce 2- 64 ounce Milk, fluid 13 Quarts (3 gal. + 1 qt) 13 Quarts whole Lowfat: skim, 1/2%, 1% or 12 qts. milk & 32 oz. (2%)* yogurt Cheese 1 # 1 # Cereals 36 ounces 36 ounces Eggs 1 dozen 1 dozen Fresh fruit & vegetables $8 cash value $8 cash value Whole wheat 2 lb loaf 2 lb loaf bread/tortillas Peanut butter OR 18 ounce 18 ounce Dry/Canned Beans & 16 ounce dry or 4 cans 16 ounce dry or 4 cans Peas *2% milk allowed with documentation when C2-4 meets risk criteria for at‐risk of underweight OR high‐risk of underweight, C1 caregiver reports the health care provider recommends 2% milk, client overweight or obesity is a concern or family history is positive for obesity, dyslipidemia, or cardiovascular disease 14 2018 7

WIC Food Package To Avoid a lost Quart , WIC has applied an odd/even rule to milk packages each month: Odd Months : 3 gallons of milk 1 half gallon milk Even Months : 3 gallons of milk 15 Under what conditions can the type of milk be changed? 16 2018 8

WIC Food Package 2% Milk (C 1 12‐24 mos) Criteria for a child 12 ‐24 months to receive 2% milk: • HCP recommends 2% milk • Overweight or obesity • Family History of obesity (No MDF required) 17 2% Milk (C 2 –C 4 ) Criteria for a child 2 ‐ 4 years old to receive 2% milk: • At‐risk of underweight (103.02) • High‐risk underweight (103.01+ ♥ ) 18 2018 9

WIC Food Package 2% Milk (PG, BE, BP, NPP) Criteria for a woman to receive 2% milk • Pre‐pregnancy underweight (101) • Postpartum underweight (102) • Low maternal weight gain (131+ ♥ ) • Maternal weight loss during pregnancy (132+ ♥ ) 19 Soy Beverage • Remains a preference for women • CPA can determine need to substitute soy beverage for children • Criteria & Documentation for Children : • Milk Allergy • Lactose Intolerance • Vegetarian/Vegan Diet • Cultural Practice (includes religious practice) 20 2018 10

WIC Food Package SOY PACKAGES: • NO YOGURT • NO CHEESE 21 ALLOWABLE FOOD SUBSTITUTIONS 22 2018 11

WIC Food Package 3 quarts Milk = 1# Cheese 23 CHEESE LIMITS • BE MAX : No more than 2# of cheese may be substituted for milk (1.5 gal), for a total of 3# CHEESE. • PG, BP, NPP & C1-C4 (Standard): No more than 1# of cheese may be substituted for 3 qts. of milk . 24 2018 12

WIC Food Package Substitutions: Infant cereal for breakfast cereal For children and women: 32 oz. of infant cereal may be substituted for 36 oz. of breakfast cereal. No MDF required 25 Substitutions ‐ Evaporated milk • 20 cans evaporated milk = 16 quarts fluid milk + 1 quart fluid milk • 28 cans evaporated milk = 22 quarts fluid milk + 1 quart fluid milk. • 32 cans evaporated milk = 24 quarts fluid milk 26 2018 13

WIC Food Package Substitutions – Powdered dry milk • 64 oz. box powdered dry milk = 20 quarts fluid milk • 32 oz. box powdered dry milk = 10 quarts fluid milk • 25.6 oz. box powdered dry milk = 8 quarts fluid milk • Need to specify container size that client’s vendor carries 27 Finding the milk: ‐Evaporated Fat Free and Whole ‐NFDM=Non‐Fat Dry Milk 28 2018 14

WIC Food Package Child Food Packages 29 Milk Packages • If a food package states “Gallon,” milk MUST be bought in the Gallon form. It cannot be split in exchange for 2 one half gallons. • Milk packages do come in quarts. Client must buy the milk in quarts, as stated on their shopping list. They will not be able to buy the milk in the gallon form at the store. They have to buy the size of milk it states on their shopping list. Exception: Lactose free milk in quarts or equivalents. • Milk quart packages work well for clients with limited storage or if they are not able to consume a gallon of milk within a short period of time. 30 2018 15

WIC Food Package C1 MAX (whole milk) Odd Month: 3 GAL 0.5 HGL 31 C2/C3/C4 MAX (LOWFAT MILK/Yogurt) Chose Yogurt: 32 2018 16

WIC Food Package FOOD PACKAGES FOR WOMEN 33 NPP MAX (LOWFAT MILK) 2015 (NO WHOLE GRAINS) 34 2018 17

WIC Food Package NPP MAX (LOWFAT MILK/Yogurt) 2016 (NO WHOLE GRAINS) 35 Food Packages BE & PG/BP BE PG/BP FOOD PACKAGE Juice 144 ounces 144 ounces (48 OZ. OR 11.5-12 OZ CAN) (48 OZ. OR 11.5-12 OZ CAN) Milk, fluid (skim, ½%, 1%) 4 ½ gallons (18 quarts) 4 gallons, 3 qts. (19 quarts) or 18 quarts & 32 oz. yogurt Or 17 quarts & 32 oz. yogurt Cheese 3 # 1 # Cereals 36 ounces 36 ounces Eggs 2 dozen 1 dozen Fresh fruit & vegetables $11 cash value $11 cash value Whole wheat bread/tortillas 1 lb loaf 1 lb loaf Peanut butter 18 ounce 18 ounce Dry/Canned Beans & Peas 16 ounce dry or 4 cans 16 ounce dry or 4 cans Fish (canned) 30 oz.: (6- 5oz. Cans) -- 36 2018 18

WIC Food Package BE MAX 2015 4 GAL MILK, 1 HGL milk, 3# CHEESE 37 BE MAX (1# CHEESE) 2015 6 GAL Milk, 1 # Cheese 38 2018 19

WIC Food Package BE MAX (2#CHEESE/YOGURT) 2016 (2# CHEESE, 5 GAL MILK, 32 OZ. YOGURT) 3 QUARTS MILK = 1# CHEESE 39 BE MAX (LACTOSE FREE LOWFAT MILK/YOGURT) 2016 LF Milk comes in quarts (QT) or equivalents (EQV) . It can be bought as quarts, half gallons or 96 oz containers (3 quarts). 40 2018 20

WIC Food Package BE PACKAGES FOR SPECIAL CONDITIONS 41 BE Food Packages • PG TWINS : Expecting more than 1 infant • BP TWINS : Breastfeeding more than 1 infant (2 IBP or IBE & IBP) • BP & PG • BE & PG Breastfeeding while PG 42 2018 21

WIC Food Package 43 BE max * 1.5 BE: Breastfeeding Exclusively 2 or more infants 2 IBE 44 2018 22

WIC Food Package 45 Breastfeeding Twins: BE MAX*1.5 {2 IBE} 46 2018 23

WIC Food Package BE * 1.5 Food Package Update It has been noted that the following food packages: • BE MAX (YOGURT) 2016 • BE MAX (INFANT CEREAL/YOGURT) 2016 for mothers EXCLUSIVELY BREASTFEEDING (BE) more than one child from the same pregnancy, are issuing UNREDEEMABLE QUANTITIES OF MILK in the half gallon (HGL) unit. 47 Yogurt Packages for BE * 1.5 • BE MAX (2# CHEESE/YOGURT) 2016 • BE MAX (MILK IN QUARTS/YOGURT) 2016 • BE MAX (LACTOSE FREE LOWFAT MILK/YOGURT) 2016 48 2018 24

WIC Food Package IBE/IBP Infant Breastfeeding Packages 49 Mom & Baby’s Records MUST be linked MUST reflect same category of woman and infant • BE/IBE • BP/IBP • NPP/IFF 50 2018 25