WIC Policy & Procedure Manual
Policies and procedures for the New Hampshire Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)
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 & Management
- Nutrition Services Administration (NSA) Expenditures
- Caseload Management
- Certification, Eligibility & Coordination of Services
- Food Delivery and Food Instruments
- Monitoring & 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
A. Nutrition Education
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
B. Food Package Design
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 Formulas
- Milk and Milk Alternatives
- Proration
- Unused and Returned Formula
Attachments
- NH StarLINC Base Food Package Quick Guide
- NH WIC Approved Foods Pamphlet
- NH WIC Food List Updates
- Alimentos Aprobados por NH WIC
- Actualizaciones de Paquetes de Alimentos
- 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
- Mixing Powder Infant Formula
- Preparación de la Fórmula para Bebés en Polvo
- Preparing Ready to Feed OR Liquid Concentrate Formula
- Preparación de la Fórmula para Bebés Lista para Usar O Líquida Concentrada
- Protect Your Baby from Cronobacter
C. Staff Training
Policy
Attachments
- VENA Competency State Agency and Self-Evaluation
- New Staff Task Checklist - Nutritionist
- New Nutritionist/Breastfeeding Orientation Checklist
- Training Outreach and Meeting (TOM) Log
D. Breastfeeding Promotion and Support
Breastfeeding Promotion Services
Policy
- Breastfeeding Promotion
- Materials Distributed to Participants
- Breastfeeding Reports
- Electric Breast Pump Loan Program
- Single User or Personal Use Electric Breast Pumps
- Manual Pump Issuance
Attachments
- Six Steps to a Breastfeeding Friendly WIC Clinic
- Six Steps to a Breastfeeding Friendly WIC Clinic Checklist
- Staff Role - Designated Breastfeeding Expert (DBE) - Job Description
- Staff Role - Designated Breastfeeding Expert (DBE) - Scope of Practice
- 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
- Checklist for Issuing a Manual Breast Pump
- Breastfeeding User Agreement (English)
- Breastfeeding User Agreement (Spanish)
- Letter Template For Lost Breastpump
Breastfeeding Peer Counseling Program
Policy
- Breastfeeding Peer Counseling Program Description
- Breastfeeding Peer Counseling Documentation
- Breastfeeding Peer Counseling Program Cell Phone and Texting Policy
Attachments
- WIC Breastfeeding Support Model for Peer Counselors
- Breastfeeding Peer Counseling Job Description
- Quarterly Breastfeeding Peer Counseling
- Breastfeeding Peer Counseling Activity Worksheet
- Breastfeeding Module Screen Shots
- Breastfeeding Peer Counseling Program Cell Phone Agreement
Chapter 3: STARLinc Operations
Policy
Attachments
Chapter 4: Organization and 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
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
- Eligibility Criteria
- Documentation of Certification
- Physical Presence
- Proof of Identity
- Proof of Residency
- Proof of Income
- Income Eligibility Guidelines
- Adjunctive Eligibility
- Over-Income & Ineligible Notification
- Confidentiality
- No Proof & Zero Income
- Remote Certification with Waivers for Physical Presence
- Remote Follow-up Nutrition (FUN), High Risk, or Professional Discretion High Risk FUN Appointments with Waivers for Physical Presence
Attachments
- Manual Back-Up Forms - Infant/Child
- Manual Back-up Forms- Women
- Income Guidelines
- NH Military Income Chart
- Denial of Benefits/Participation Letter
- Universal Confidentiality Statement
- No Proof Form/Self Declare Form
B. Nutrition Risk Determination, Documentation and Priority Assignment
Policy
- Anthropometrics
- Hemoglobin & Hematocrit Screening
- Nutrition Risk Assessment
- Priority Assignment
- High Priority Participants
- Sharps Disposal
Attachments
- NH Early Childhood Health Assessment Record/Medical Referral Form
- NH WIC Medical Documentation Form - Anthropometrics/Hemoglobin/Hematocrit/Lead
- Summary Chart of Risk Code, WHO/CDC Growth Chart Cut Off Points and NH HPIs
- Required Weight Measurements by Category
- NH Local Agency Staff Annual Anthropometrics Review
- NH WIC Risk Criteria Daily Sheets
C. Health Care Agreements, Referrals and Coordination
Policy
- Community Health Center
- NH Immunization Program
- Medicaid
- Homeless Facilities
- Referral
- Coordination with Medicaid and SNAP
- Coordination with Healthy Homes Lead Poisoning and Prevention Program
Attachments
D. Processing Standards
Policy
E. Certification Periods
Policy
F. Transfer of Certification
- Transfer Into State
- Transfer Out Of State
- Transfer Within State
- Verification of Certification (VOC) Steps
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
Attachments
- Race Ethnic Descriptions
- WIC Rights and Rules
- Derechos y Normas de WIC (Spanish)
- Rights and Rules Script
- How to Request a Fair Hearing
- Como Solicitar una Audiencia Imparcial (Spanish)
- Violation Sanction Chart
- Ejemplo A de carta de advertencia de la agencia local (Spanish)
Chapter 9: Food Delivery/Food Instrument/Cash Value Benefit 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 Benefit Issuance Accommodations
Policy
- Mailing eWIC Cards
- Replacement of eWIC Cards
- Replacement of eWIC Cards and Benefits Due to Custody or Guardianship Change
- Voiding and Replacing eWIC Benefits
- Remote Benefit Issuance
Attachments
Chapter 10: Monitoring and 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
- Quick Reference Checklist
- Special Formula Record Review Form
- Training, Outreach, and Meeting (TOM) Log Template
- Annual Requirement for WIC Staff
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
- Customer Services, Conflict Resolution, Respect.Civility and Diversity, Equity and Inclusion Videos
- CS Self-Assessment
- CR Complaint Log