WSR 19-16-107
PERMANENT RULES
DEPARTMENT OF HEALTH
[Filed August 2, 2019, 12:50 p.m., effective September 2, 2019]
Effective Date of Rule: Thirty-one days after filing.
Purpose: WAC 246-790-500 Definitions and 246-790-530 WIC participant violations and sanctions; special supplemental nutrition program for women, infants, and children (WIC). The department of health is adopting amendments to comply with federal requirements.
The purpose of the rule making is to remove "and breast pumps" from the definition of "WIC benefits" in WAC 246-790-500(26) and to add "one or" to WAC 246-790-530 dual participation sanction.
Citation of Rules Affected by this Order: Amending WAC 246-790-500 and 246-790-530.
Statutory Authority for Adoption: RCW
43.70.120.
Other Authority: 7 C.F.R. 246.
Adopted under notice filed as WSR 19-05-021 on February 12, 2019.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 2, Repealed 0; Federal Rules or Standards: New 0, Amended 2, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.
Number of Sections Adopted at the Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's own Initiative: New 0, Amended 2, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 2, Repealed 0.
Number of Sections Adopted using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 2, Repealed 0.
Date Adopted: July 30, 2019.
John Wiesman, DrPH, MPH
Secretary
AMENDATORY SECTION(Amending WSR 18-23-080, filed 11/19/18, effective 12/20/18)
WAC 246-790-500Definitions related to participant compliance.
The definitions in this section apply to this section through WAC 246-790-570 unless the context clearly indicates otherwise.
(1) "Appeal" means a formal proceeding where a participant who has received a notice of violation from the department has the opportunity to present his or her case in an impartial setting and be heard by the department.
(2) "Applicant" means any pregnant woman, postpartum woman, infant, child, or caregiver of an infant or child who is applying to receive WIC program benefits, or a breastfeeding infant of an applicant breastfeeding woman. Applicants include individuals who are currently participating in the program but are applying because their certification period is about to expire.
(3) "Authorized supplemental foods" means those supplemental foods authorized by the department for issuance to a particular participant.
(4) "Certification" means the implementation of criteria and procedures to assess and document each applicant's eligibility for participation in the WIC program.
(5) "C.F.R." means Code of Federal Regulations.
(6) "Claim" means a type of sanction demanding repayment for misuse of WIC/farmers' market nutrition program (FMNP) benefits by a WIC participant.
(7) "Deliberate" means acting intentionally, knowingly and voluntarily.
(8) "Department" means the Washington state department of health.
(9) "Disqualification" means the act of ending the WIC program participation of a participant, whether as a punitive sanction or for administrative reasons.
(10) "Dual participation" means program participation in one or more than one WIC clinic.
(11) "Eligibility criteria" means the reasons people qualify for WIC program benefits as described in 7 C.F.R. Sec. 246.7(c).
(12) "Farmers' market nutrition program (FMNP)" means a program to provide fresh, unprepared, locally grown fruits and vegetables to WIC participants, and to expand the awareness, use of, and sales at farmers' markets.
(13) "Food instrument" means the method of payment used by a participant to obtain WIC-approved foods. These methods may include WIC checks, WIC farmers' market nutrition program checks, cash value vouchers, or electronic benefit transfer (EBT) payments.
(14) "Local agency" means:
(a) A public or private nonprofit health or human services agency that provides health services either directly or through contract with the department to provide services in accordance with 7 C.F.R. Sec. 245.5;
(b) An Indian health services unit in contract with the department to provide services;
(c) An Indian tribe, band or group recognized by the department; and/or
(d) An intertribal council or group that is an authorized representative of Indian tribes, bands or groups.
(15) "Notice of violation" means a written document given to a participant, or caregiver of an infant or child participant, when the department determines a participant or caregiver of an infant or child participant, has not complied with WIC program requirements, federal WIC regulations, this chapter, or the participant rights and responsibilities form. This notice is a type of sanction which explains the violation and provides a warning about repercussions of subsequent violations.
(16) "Nutritional risk" means detrimental or abnormal nutritional conditions detectable by biochemical or anthropomorphic measurements; other documented nutritionally related medical conditions; dietary deficiencies that impair or endanger health; conditions that directly affect the nutritional health of a person, including alcoholism or drug abuse; or conditions that predispose persons to inadequate nutritional patterns or nutritionally related medical conditions including, but not limited to, homelessness and migrancy, as specified in 7 C.F.R. Sec. 246.2.
(17) "Participant" means a woman, infant or child receiving WIC benefits.
(18) "Participant violation" means any deliberate action of a participant, parent or caretaker of an infant or child participant, or proxy that violates federal or state statutes, regulations, policies, or procedures governing the WIC program.
(19) "Proxy" means an individual who is designated by a participant or a child or infant participant's parent, guardian, or caretaker to receive and redeem food instruments for the participant and whose name is filed with the local agency.
(20) "Restitution" means reimbursement to the department of the cash value of WIC program benefits received by a participant as the result of a sanction imposed for a violation.
(21) "Sanction" means a penalty imposed by the department of health WIC program because of a violation. The three types of sanctions are notice of violation, disqualification, and claim.
(22) "SNAP" means the federal Supplemental Nutrition Assistance Program. SNAP was previously known as the Food Stamp Program.
(23) "Vendor" means a sole proprietorship, partnership, cooperative association, corporation, or other business entity operating one or more stores authorized by the state WIC program to provide WIC-approved foods to WIC participants.
(24) "Violation" means any deliberate action of a WIC participant or caregiver of an infant or child participant, including actions listed in WAC 246-790-520 that violate federal or state statutes, regulations, policies, or procedures governing the WIC program.
(25) "WIC" means the federally funded special supplemental nutrition program for women, infants, and children as described in 7 C.F.R. Sec. 246.
(26) "WIC benefits" means benefits a participant receives that include, but are not limited to, food((,))and infant formula((, and breast pumps)).
(27) "WIC Participant Rights and Responsibilities form" means a document signed by a WIC participant or proxy showing she or he has been advised of and agrees to WIC program rights and obligations.
AMENDATORY SECTION(Amending WSR 18-23-080, filed 11/19/18, effective 12/20/18)
WAC 246-790-530WIC participant violations and sanctions.
(1) When any WIC participant or caregiver deliberately violates federal or state statutes, regulations, policies or procedures governing the WIC program, the department will initiate appropriate enforcement action, which may include establishment of claims under WAC 246-790-550 or disqualification under WAC 246-790-560. Violations and applicable sanctions are listed below:
Violations | 1st Instance | 2nd Instance | Subsequent Instances |
Attempting to redeem a food instrument for unauthorized foods or formula. | Notice of violation | Notice of violation | 6-month disqualification |
Redeeming a food instrument for unauthorized foods or formula. | Notice of violation and claim | 1-year disqualification and claim | 1-year disqualification and claim |
| 1-year disqualification and claim if claim is $100 or more | | |
Attempting to return foods purchased with a food instrument to a WIC vendor in exchange for money, credit, a different food or food in excess of those on the food instrument. | Notice of violation | Notice of violation | 6-month disqualification |
Returning foods purchased with a food instrument to a WIC vendor in exchange for money, credit, a different food, or food in excess of those on the food instrument. | Notice of violation and claim | 1-year disqualification and claim | 1-year disqualification and claim |
1-year disqualification and claim if claim is $100 or more | | |
Redeeming a food instrument reported as lost or stolen, and then replaced. | Notice of violation and claim | 1-year disqualification and claim | 1-year disqualification and claim |
| 1-year disqualification and claim if claim is $100 or more | | |
Destruction of vendor, farmer or local agency property during a WIC transaction or visit. | Notice of violation if replacement or repair cost is less than $100 | 1-year disqualification | 1-year disqualification |
| 6-month disqualification if replacement or repair cost is $100 or more | | |
| Note: Replacement or repair cost will be determined by affected vendor, farmer or local agency | | |
Destruction of state agency property during a WIC visit. | Notice of violation and claim if claim is less than $100 | 1-year disqualification | 1-year disqualification |
| 1-year disqualification and claim if claim is $100 or more | | |
Altering a food instrument. | 6-month disqualification and claim if claim is less than $100 | 1-year disqualification and claim | 1-year disqualification and claim |
| 1-year disqualification and claim if claim is $100 or more | | |
Making false or misleading statements or deliberately misrepresenting, concealing or withholding facts to obtain or increase benefits. | Notice of violation and claim if claim is less than $100 | 1-year disqualification and claim | 1-year disqualification and claim |
1-year disqualification and claim if claim is $100 or more | | |
Participating in and spending WIC food instruments from one or more than one WIC clinic during the same time period (dual participation). | 1-year disqualification and claim | 1-year disqualification and claim | 1-year disqualification and claim |
| | |
Threatening to harm or physically harming clinic, farmer or vendor staff during a WIC visit. | 6-month disqualification | 1-year disqualification | 1-year disqualification |
Failure to comply with department or local agency request for information during an investigation. | 1-year disqualification | 1-year disqualification | 1-year disqualification |
Selling, attempting to sell, exchanging, attempting to exchange, or allowing another person to sell food instrument or exchange food or formula purchased with a food instrument for cash, credit, merchandise, favors, or other nonfood items (trafficking) verbally, in print, or online through web sites or social media. | Notice of violation and claim if claim is less than $100 1-year disqualification and claim if claim is $100 or more | 1-year disqualification and claim | 1-year disqualification and claim |
Theft of a food instrument by a WIC participant. | 1-year disqualification and claim | 1-year disqualification and claim | 1-year disqualification and claim |
(2) During each certification visit, participants will be informed of their rights and responsibilities, program rules, and that there may be potential sanctions should they deliberately violate a program rule.
(3) Whenever the department assesses a claim of misappropriated WIC program benefits of one hundred dollars or more resulting from a participant violation, assesses a claim for dual participation, or assesses a second or subsequent claim of any amount resulting from a participant violation, the department must disqualify the participant for one year.
(4) The department may decide not to impose a disqualification if, within thirty days of the date the letter was mailed demanding repayment, full restitution is made or a repayment schedule is agreed upon. In the case of a violation committed by the parent or caretaker of an infant or child participant, or by a participant under the age of eighteen, the department may approve the designation of a proxy in order to continue program benefits to these participants.
(5) Participants may reapply for benefits at any time after the disqualification period concludes.
(6) The department must consider designating a substitute caregiver instead of disqualification for infants, children, and women under eighteen years of age.
(7) Second and subsequent instances of violations are assessed based on a twelve-month period from the first notice that a violation has occurred.