WIC Policy and Procedure Manual
The New Hampshire Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Policy and Procedure Manual is developed by the State Agency for guidance to local agencies in operating the WIC Program. The Manual is updated twice a year to include new policies and updates in response to changes in federal regulations and federal policies.
The manual includes policies in the following areas:
- Vendor Management
- Nutrition and Breastfeeding Services
- StarLINC Operations
- Organization and Management
- Nutrition Services and Administration Expenditures
- Caseload Management
- Certification, Eligibility, and Coordination of Services
- Food Delivery and Food Instruments
- Monitoring and Evaluation
- Civil Rights
Per federal regulation, the policy and procedure manual is developed by the State Agency for guidance to local agencies in operating the Program. The manual includes certification procedures, including the specific nutritional risk criteria by priority level which explains how a person’s nutritional risk is determined, hematological data requirements including timeframes for the collection of such data, procedures for requiring proof of pregnancy, the State Agency’s income guidelines for Program eligibility, methods for providing nutrition education to participants, including information on drug abuse and other harmful substances, instructions concerning all food delivery operations performed at the local level, including the list of acceptable foods and their maximum monthly quantities, instructions for providing all records and reports which the State agency requires local agencies to maintain and submit, and instructions on coordinating operations under the program with drug and other harmful substance abuse counseling and treatment services.
Any questions concerning the Policy and Procedure Manual may be directed to the WIC Program.
Chapter 1: Vendor Management
Policy
Attachments
Chapter 2: Nutrition and Breastfeeding Services
Policy
- Nutrition & Breastfeeding Services Survey

- Nutrition & Health Assessment – VENA

- Nutrition Education

- Nutrition Education – Alternative Modes

- Nutrition Education for Homeless

- Nutrition Services Documentation

- Nutrition Education Materials

- Substance Abuse Screening, Referral & Education

- Exit Counseling

Attachments
- Diet Assessment
- Getting to the Heart of the Matter (GTHM)
- Value Enhanced Nutrition Assessment (VENA)
- USDA Policies & Guidelines
- Value Enhanced Nutrition Assessment (VENA) Food and Nutrition Service (FNS)WIC Nutrition Assessment 2006-5

- United States Department of Agriculture (USDA) FNS WIC Nutrition Education Guidance 01-06

- USDA FNS WIC Nutrition Education Guidance Appendix-A Electronic

- USDA FNS WIC Nutrition Education FAQs

- USDA FNS WIC Nutrition Services Documentation 2008-4

- Value Enhanced Nutrition Assessment (VENA) Food and Nutrition Service (FNS)WIC Nutrition Assessment 2006-5
Policy
- Food Package I – Infants 0 through 5 Months

- Food Package II – Infants 6 through 12 Months

- Food Package III – Special Formula all WIC Categories with Quality Medical Conditions

- Food Package IV – Children 1 through 5 Years of Age

- Food Package V – Pregnant & Mostly Breastfeeding

- Food Package VI – Postpartum & Limited Breastfeeding

- Food Package VII – Exclusively/Fully Breastfeeding, Breastfeeding multiples & Pregnant with multiples

- Food Package Tailoring – Including Homeless

- Special Formula Provided through NH Medicaid/Managed Care Organizations

- Contract Formula

- Milk and Milk Alternatives

- Proration

- Unused and Returned Formula

Attachments
- NH StarLINC Base Food Package Quick Guide

- NH WIC Approved Foods Pamphlet (English)

- NH WIC Approved Foods Pamphlet (Spanish)

- Infant Feeding Chart – More and More Rewards

- Donor Milk & WIC Food Package

- Breastfeeding and Postpartum Women/Infant Categories and Definitions

- Request for Special Formula and Supplemental Foods Form

- Request for Standard Formula without Foods Form

- NH WIC Program Formulary

- Food Package Tailoring Options

- Formula Assessment Tool

- Returned/Donated/Destroyed Formula Tracking Sheet

Policy
Attachments
- VENA-GTHM Competency Self-Evaluation

- VENA-GTHM Counseling Skills State Agency Visit

- New Staff Task Checklist – Nutritionist

- New Nutritionist/Breastfeeding Orientation Checklist

- Training Outreach and Meeting (TOM) Log

D. Breastfeeding Promotion and Support ![]()
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- Breastfeeding Promotion Services
Policy
- Attachments
- Six Steps to a Breastfeeding Friendly WIC Clinic

- Six Steps to a Breastfeeding Friendly WIC Clinic Checklist

- How to Issue a Manual Breast Pump

- How to Issue an Electric Breast Pump

- Checklist for Issuing an Electric Breast Pump

- Checklist for Returning an Electric Breast Pump

- BF User Agreement (English)

- BH User Agreement (Spanish)

- Letter Template for Lost Breast Pump

- Six Steps to a Breastfeeding Friendly WIC Clinic
- Breastfeeding Peer Counseling Program
Policy
- Attachments
Chapter 3: STARLinc Operations ![]()
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Policy
Chapter 4: Organization & Management ![]()
Policy
- Local Agency Staffing Requirements

- WIC Staffing Ratios

- Disaster Planning

- Conflict of Interest

- Separation of Duties

- Notification of Federal and State Requirements

- Single Staff Certifications (SSC)

Attachments
- Conflict of Interest/Separation of Duties Sample

- Single Staff Certifications (SSC) Record Review Form

- Unexpected SSC Tracking Log

Chapter 5: Nutrition Services Administration (NSA) Expenditures ![]()
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Policy
- Equipment & Computer Procurement

- Inventory

- Disposal, Repurpose, Transfer, and Deletion of Inventory

- Time Studies & Billing

- Nutrition Education Costs

Attachments
Chapter 6: Food Funds Management – refer to State Plan ![]()
Chapter 7: Caseload Management ![]()
Policy
- No Show Rate

- Caseload Monitoring

- Benefit Targeting

- Allocation of Caseload

- Allocation of Funds

- Waiting List

Attachments
- No Show and No Rescheduled Appointment Report

- Caseload Management Report

- Participation by Age Report

- Participation by Priority Report

Chapter 8: Certification, Eligibility & Coordination of Services
- A. Eligibility Determination and Documentation

Policy
- Attachments
- B. Nutrition Risk Determination, Documentation and Priority Assignment

Policy
- Attachments
C. Health Care Agreements, Referrals, and Coordination 
Policy
- Community Health Center

- NH Immunization Program

- Medicaid

- Homeless Facilities

- Referral

- Coordination with Food Stamps

- Coordination with Healthy Homes Lead Poisoning and Prevention Program

- Community Health Center
- D. Processing Standards

Policy
- E. Certification Periods

Policy
- F. Transfer of Certification

Policy
- G. Dual Participation, Participant Rights and Responsibilities, Fair Hearing
Procedures, and Sanction System
Policy
- WIC Bordering States Dual Participation

- Dual Participation Check-In State

- Ethnicity and Race

- Program Explanation & Basic Contacts

- Participant Rights and Rules

- Participant Right to a Fair Hearing

- Participant Notice of Violation – Warning

- Participant Notice of Violation – Disqualify

- Selling WIC Program Benefits

- WIC Bordering States Dual Participation
- Attachments
- Race Ethnic Descriptions

- WIC Program Rights and Rules Signature Form (English)

- WIC Program Rights and Rules Signature Form (Spanish)

- Rights and Rules Script

- Mandatory Appeal Language (Right to a Fair Hearing – Print and Online versions) (English)

- Mandatory Appeal Language (Right to a Fair Hearing – Print and Online versions) (Spanish)

- Violation Sanction Chart

- Warning Notice Sample Letters (English)

- Warning Notice Sample Letters (Spanish)

- Race Ethnic Descriptions
Chapter 9: Food Delivery/Food Instrument/Cash Value Voucher Accountability and Control ![]()
- A. Food Delivery and Food Instrument Control

Policy
- Attachments
- B. Food Instrument Pick-up and Transaction

Policy
- Attachments
- C. Special Food Instrument and Cash Value Voucher Issuance Accommodations

Policy
Chapter 10: Monitoring & Evaluation ![]()
Policy
Attachments
- NH DHHS WIC Local Agency Clinic Evaluation Guide

- NH DHHS WIC Local Agency Management Evaluation – Clinic Staff/Customer Service

- Record Review Form 10

- Record Review Form 15

- Quick Reference Checklist

- Special Formula Record Review Form

- Training, Outreach, and Meeting (TOM) Log Template

Chapter 11: Civil Rights ![]()
Policy
- Public Notification Requirement and Nondiscrimination Statement

- Compliance Review and Monitoring Activity

- Applicant & Participant Complaint Handling

- Handicapped Accessible WIC Clinics

Attachments
- Civil Rights Poster and Justice for All

- NH DHHS Nondiscrimination Poster (English)

- NH DHHS Nondiscrimination Poster (Spanish)

- “I Speak” Poster

- Conflict Resolution (CR) Customer Service (CS) Training

- CR Case Studies

- CR/CS Videos

- CR Top 12 Approaches to CR

- CS Self-Assessment

- CR Complaint Log

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