Looking at other agency capabilities, an overwhelming majority of the agencies reported that they 

can perform hematological tests (89.2%), and all local agencies (100.0%) reported the ability to take 

anthropometric measurements for weight, body mass, and height. 

April 2012 
Non-Discrimination Policy 

The U.S. Department of Agriculture (USDA) prohibits discrimination in all of its programs and activities 

on the basis of race, color, national origin, age, disability, and where applicable, sex, marital status, 

familial status, parental status, religion, sexual orientation, political beliefs, genetic information, reprisal, 

or because all or part of an individual’s income is derived from any public assistance program. (Not all 

prohibited bases apply to all programs.) 

Persons with disabilities who require alternative means for communication of program information 

(Braille, large print, audiotape, etc.) should contact USDA’s TARGET Center at (202) 720-2600 (voice 

and TDD). To file a complaint of discrimination, write: USDA, Director, Office of Adjudication, 1400 

Independence Ave., SW, Washington, DC 20250-9410 or call (866) 632-9992 (Toll-free Customer 

Service), (800) 877-8339 (Local or Federal relay), (866) 377-8642 (Relay voice users). USDA is an equal 

opportunity provider and employer. 
National Survey of WIC Participants II

Volume 2: State and Local Agencies (Final Report)

Authors:

Daniel M. Geller, Marcia Harrington, 

Andrey Vinokurov, et al.

Submitted by: 

ICF Macro 

11785 Beltsville Drive, Suite 300 

Calverton, Maryland 20705 

Submitted to: 

USDA, Food and Nutrition Service 

3101 Park Center Drive 

Alexandria, Virginia 22302 

Project Director: 

Daniel M. Geller 

Project Officer: 

Karen Castellanos-Brown 

Sheku Kamara 

This study was conducted under contract number: AG-3198-D-07-0105 with the Food and 

Nutrition Service. 

This report is available on the Food and Nutrition Service website: http://www.fns.usda.gov/ora. 

Suggested citation: 

U.S. Department of Agriculture, Food and Nutrition Service, Office of Research and Analysis, 

National Survey of WIC Participants II: State and Local Agencies Report, by Daniel M. Geller, 

et al. Project Officers: Karen Castellanos-Brown, Sheku G. Kamara, Alexandria, VA: 2012. 

April 2012 

Special Nutrition Programs 

Report No. CN-10-NSWP-II-R2 
 ii National Survey of WIC Participants II 

ACKNOWLEDGMENTS

ICF Macro would like to thank each of the State Special Supplemental Nutrition Program for 

Women, Infants, and Children (WIC) agencies that provided sampling frame information and 

participant data from local entities that were selected during sampling. We also would like to 

thank local clinics/agencies that supported our field interviewers by acknowledging the 

importance of their work and helping them obtain updated contact information for participants, 

when possible. In addition, we want to thank State agencies in West Virginia and the District of 

Columbia, which supported pretesting activities. Directors and IT leads and others from several 

State agencies provided extra support along the way in various capacities: Cynthia Melde 

(Arizona), Ruth Caldwell (California), Richard Bates (Colorado), Debbie Eibeck (Florida), 

Tim Mooney and Holly Esford (New York), and many others, too numerous to name. Finally, 

we would like to thank all those at the Food and Nutrition Service who helped us accomplish so 

many things necessary to the completion of the National Survey of WIC Participants II. 
 iii National Survey of WIC Participants II 

CONTENTS

Acknowledgments ii

Executive Summary v

Chapter 1. Overview of the WIC Program and Program Eligibility 1

1.1 Goals of the Study 2

Chapter 2. The Study Methodology 4

2.1 Source of Data 4

2.2 Survey Content 5

State Policies and Procedures 5

Local Agency Policies and Operations 6

2.3 Sample Design 6

Sampling of Local WIC Agencies 6

Sample Size 7

The Sampling Frame for the National Sample of Local Agencies 7

Selection of the Local Agency Sample 7

Sampling Procedure 8

Weighting 8

2.4 Analysis 9

Chapter 3. State WIC Agency Findings 10

3.1 Size and Organization of State Agency 10

3.2 Food Packages and Nutritional Services 12

Breastfeeding Services 12

Food Instrument Distribution 13

WIC Nutrition Risk Criteria 14

3.3 Certification Process 16

Income Eligibility 17

State and Local Agencies 20

Family Economic Unit 21

Adjunctive Eligibility 22

Certification Period 23

Residential Eligibility 24

Denials 27

Proxies 28
Volume 2: State and Local Agencies (Final Report)

 iv National Survey of WIC Participants II 

3.4 Recordkeeping and Systems 29

Recordkeeping at the State Agency Level 29

Recordkeeping at the Local Agency Level 30

Chapter 4. Local WIC Agency Findings 32

4.1 Local Agency Size and Organization 32

Capabilities of Local Agencies Overall 35

Nutrition Services and Administration Funds 38

4.2 Participant Profile 38

4.3 Staff and Participant Caseload 40

Staff Levels 40

Staffing Issues 45

Language Capabilities 46

4.4 Characteristics of the Local Agency Primary Site 50

Location and Operations 50

Physical Structure and Equipment 52

Safety and Transportation 53

Participant Transportation 53

4.5 Participant Services Offered at Main Local Agency Site 55

4.6 Nutrition Education 61

4.7 Agency Procedures at the Main Local Agency Site 64

Certifications 64

Role of Proxies 65

Denied Certification and Recertification 65

Controls against Duplicate Participation 67

Appendices 

Appendix A: State Agency Survey Instrument 

Appendix B: Local Agency Survey Instrument 

Appendix C: State Agency Data Cross-Tabulation Tables 

Appendix D: Local Agency Data Cross-Tabulation Tables 
 v National Survey of WIC Participants II 

EXECUTIVE SUMMARY

Introduction 

For 35 years, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) 

has provided benefits to low-income, pregnant, and new mothers and their young infants and 

children who are at nutritional risk. The WIC Program, the United States Department of 

Agriculture’s (USDA) third largest nutrition assistance program, serves more than 9 million 

participants monthly and has been growing consistently. Half of the participants are children age 1 

to 5 years; one quarter are infants (0-12 months of age); and the remaining quarter are, in 

descending order, pregnant, postpartum (i.e., non-breastfeeding), and breastfeeding women. 

This report, the second of three for the National Survey of WIC Participants II (NSWP-II), 

addresses the second goal of the study, which is to provide information on the policies, procedures, 

operations, and staff at State and local WIC agencies. 

This study is a follow-up to the first National Survey of WIC Participants (NSWP-I), for which 

data were collected in 1998 and a report was issued in 2001. Data for this Second National 

Survey of WIC Participants (NSWP-II) were collected in late 2009. 

Survey Methodology 

State Agencies 

The State survey consisted of a census of all 90 State WIC agencies:1 50 States and the District of 

Columbia (henceforth referred to as “States/DC”), 5 U.S. Territories, and 34 Indian Tribal 

Organizations (ITOs). While all the WIC State agencies were supposed to comply, responses were 

received from 82 State agencies (91%), made up of 50 States/DC, 27 ITOs, and 5 U.S. Territories. 

Within the Federal guidelines, State agencies have considerable authority over their State’s WIC 

Program operation, including defining selected eligibility criteria, negotiating food prices, 

specifying application and payment procedures, and establishing program data management 

systems. State agencies also have discretion over many important issues in eligibility determination; 

their use of this discretion is an important focus of the State survey. While State agencies have 

typically used—and continue to use—considerable discretion in the administration of their 

programs, where permitted by the Food and Nutrition Service (FNS), common statewide systems 

seem to leave less leeway to the local agencies. The State WIC Agency Survey findings will report 

the extent to which each of these discretionary powers is exercised in both eligibility determination 

and WIC Program administration. 

 

1 The term “State agencies” refers collectively to all State, District of Columbia, U.S. Territory, and ITO agencies. 
Volume 2: State and Local Agencies (Final Report)

 vi National Survey of WIC Participants II 

Findings 

Overview 

While State agencies vary widely in size, there are some consistent patterns in the ways they 

administer the WIC program. In certification, half of the State agencies grant discretion to local 

agencies on income eligibility, but less than half permit any discretion of criteria for determining 

the family economic unit. There is little variation among State agencies in the types of income 

included for income eligibility; nearly two-thirds use current income, which is defined as income 

covering the most recent 30 days or the most recent pay period. State agencies retain 

considerable amounts of data electronically, with about one-third retaining each of several types 

of eligibility documentation. In contrast, State agencies reported that little documentation is 

retained at local agencies, except on nutritional eligibility. 

Characteristics of State WIC Agencies 

The average State WIC agency oversees 109,395 participants per month, and 26 local agencies 

and 91 clinics or other sites (Exhibit ES-1). The averages obscure the wide ranges, which run 

from 0 to 118 for local agencies, and 0 to 625 for local clinics. Overall, 25 State agencies 

reported having zero or one local agency, and 14 reported having zero or one local clinic. 

At small ITOs, the distinction between State agency, local agency, and clinic is not always clear, 

since a single site may serve as a de facto State agency, local agency, and clinic. 

Exhibit ES-1: Number of Local Agencies and Clinics under State WIC Agency 

Sites under the State 

agency...

Type of organization Number of participants 

Total 

States/

DC ITO 

U.S. 

Territory

Up to 

10,000 

10,000 

to 

74,999 75,000+ 

(n=50) (n=27) (n=5) (n=29) (n=21) (n=32) (n=82)

% % % % % % %

WIC local agencies 

 Average number 39.7 2 20.2 1.3 15.5 55.4 26.1 

 Median number 24 1 1 1 12 49 12 

 Range 0–118 0–12 0–93 0–7 0–63 10–118 0–118 

WIC clinics or sites 

 Average number 144.5 7.3 3.8 5.2 54.7 192 90.8 

 Median number 113 5 3 3 54 152.5 52.5 

 Range 0–625 0–54 0–7 0–18 1–105 0–625 0–625 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

As expected, the more populous the jurisdiction of the State agency, the more local agencies and 

clinics it has. Some jurisdictions operate without local agencies or without clinics. 
Volume 2: State and Local Agencies (Final Report)

 vii National Survey of WIC Participants II 

Food Packages and Nutrition Services 

Breastfeeding services 

High percentages of State agencies reported allocating funds for breastfeeding coordinators/peer 

counselors (90.2%) and training for personnel to support breastfeeding (93.9%). This reflects the 

national program emphasis on breastfeeding promotion. Moreover, nearly all State agencies 

provide printed breastfeeding materials, such as handouts and posters, to their participants 

(93.9%) or distribute free breast pumps to new mothers (93.9%). 

Food Instrument Distribution 

Most States/DC, ITOs, and U.S. Territories (98.9%) distribute food vouchers to WIC participants 

onsite, for redemption at approved food stores. If WIC participants are physically/medically 

unable to travel to their local WIC clinic and do not have a proxy, State agencies often mail the 

vouchers to them. States that do not use food vouchers include Mississippi, which hands out a 

monthly food package at the clinic, and Vermont, which delivers food benefits to the home by a 

private home-delivery vendor, usually biweekly. At the time of the study, two States, Texas and 

Michigan, no longer distributed food vouchers onsite, using electronic benefit transfer (EBT) 

cards instead. 

WIC Nutrition Risk Criteria 

Before 1999, Federal policy permitted State agencies to develop nutrition risk criteria within 

broad parameters spelled out in the Child Nutrition Act of 1966, as amended. Since 1999, State 

agencies have been required to use risk criteria approved by FNS to determine the WIC 

applicant’s nutritional risk. State agencies began using the Value-Enhanced Nutrition 

Assessment to improve and standardize the assessment of nutritional risk among WIC 

participants as of October 1, 2009. State agencies were asked to rank the most prevalent 

nutritional risk criteria for their State by participant category. Looking at the top prevalence rates, 

several patterns became apparent: 

 The most prevalent risk criterion for pregnant, breastfeeding, and postpartum WIC 

women was being overweight (Exhibit ES-2). To a lesser degree, agencies reported 

moderate prevalence rates among some categories of women exhibiting inappropriate 

nutrition practices, low hematocrit (i.e., anemia), and closely spaced pregnancies. 

Exhibit ES-2: Top Three Most Prevalent Risk Criteria 

in Pregnant, Breastfeeding, and Postpartum Women (n=82) 

(Percentage of State agencies reporting risk as first, second, or third most common) 

Category 

Overweight 

women 

% 

Low 

hematocrit 

% 

Closely spaced 

pregnancies 

% 

Inappropriate 

nutrition practices 

for women 

% 

Pregnant 69.5 12.2 29.3 30.5

Breastfeeding 68.2 28.0 11.0 18.3

Postpartum 67.1 41.5 18.3 25.7

Source: National Survey of WIC Participants II: State and Local Agencies Report 
Volume 2: State and Local Agencies (Final Report)

 viii National Survey of WIC Participants II 

 For infants, inappropriate nutrition practices were the most widespread risk criterion, 

with other criteria being much less prevalent (Exhibit ES-3). 

Exhibit ES-3: Top Three Most Prevalent Risk Criteria 

Among Infants in the WIC Program (n=82) 

(Percentage of State agencies reporting risk as first, second, or third most common) 

Category 

Underweight 

or at-risk 

% 

Short 

stature or 

at-risk 

% 

Low 

birth 

weight

% 

Prematurity 

% 

Inappropriate 

nutrition practices 

for infants 

% 

Infants 13.4 11.0 11.0 15.8 43.9 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

 As with infants, the most prevalent risk criterion for children is inappropriate nutrition 

practices (see Exhibit ES-4). Another risk criterion that shows up with moderate 

frequency is risk for becoming overweight; when combined with actually being 

overweight, the third most prevalent risk criterion, it reflects the threat associated 

with obesity. 

Exhibit ES-4: Top Three Most Prevalent Risk Criteria 

Among Children in the WIC Program (n=82) 

(Percentage of State agencies reporting risk as first, second, or third most common) 

Category

Overweight children 

(2–5 years of age) 

% 

At risk of becoming 

overweight 

% 

Low 

hematocrit 

% 

Inappropriate 

nutrition practices 

for children 

% 

Children 20.8 35.4 19.5 87.9 

Source: National Survey of WIC Participants II: State and Local Agencies Report

Certification Process 

The process of determining eligibility occurs through certification and is the primary 

administrative function of the WIC State agency. WIC Program regulations grant State agencies 

a certain amount of deference (or discretion) in determining income eligibility and the definition 

of income, the family economic unit, programs acceptable for adjunctive or automatic 

eligibility,2

 certification period, and proof of residency and identity. 

Income Eligibility 

When adjunctive/automatic eligibility is not established for a WIC applicant and agencies must 

calculate income, the sources of income that the State will consider are an important part of that 

determination. For some items, there is universal or widespread uniformity in State agency 

policy that the item should count as income. This includes wages, salary, fees (100%); selfemployment (97.6%), unemployment compensation (93.9%), child support (93.9%), and Social 

Security income (93.9%). Items that are considered income by 80 to 83 percent of agencies are 

 

2 Adjunctive eligibility refers to meeting the income requirements through participation in Medicaid, the Supplemental Nutrition

Assistance Program (SNAP), or Temporary Assistance for Needy Families (TANF). Automatic eligibility refers to meeting the 

income requirements through participation in a State means-tested program. 
Volume 2: State and Local Agencies (Final Report)

 ix National Survey of WIC Participants II 

alimony, regular contributions from non-household persons, workers compensation, and other 

cash income. Beyond these items, there is less consistency among State agencies (Exhibit ES-5). 

Items least likely to be considered as income are medical, rental, and energy assistance—all of 

which count towards income by less than 30 percent of State WIC agencies. 

ITOs and U.S. Territories are less likely to count many sources of income than are State agencies. 

For example, only 48.1 percent of ITOs and 60.0 percent of U.S. Territories count private 

pensions toward income eligibility, compared with 98.0 percent of State agencies. 

In a separate question, State agencies were asked about their treatment of military housing 

allowances. Most (76.8%) exclude the military Basic Housing Allowance and more than half 

exclude other allowances, such as overseas cost of living and housing (63.4% and 54.9%, 

respectively) and family separation housing (52.4%). 

Exhibit ES-5: Types of Income Counted When Determining Household Income 

Type of Income 

Type of organization Number of participants 

Total

(n=82)

% 

ITO 

(n=27) 

% 

U.S. 

Territory

(n=5) 

% 

States/DC

(n=50) 

% 

Up to 

10,000 

(n=29) 

% 

10,000 to 

75,000 

(n=21) 

% 

More than 

75,000 

(n=32) 

% 

Wages, salary, fees 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Self-employment 92.6 100.0 100.0 93.1 100.0 100.0 97.6

Unemployment compensation 92.6 40.0 100.0 82.8 100.0 100.0 93.9

Child support 85.2 80.0 100.0 82.8 100.0 100.0 93.9

Social Security 85.2 100.0 98.0 86.2 95.2 100.0 93.9

Alimony 55.6 80.0 98.0 55.2 95.2 100.0 82.9

Regular contributions from 

persons not in household 51.9 80.0 100.0 55.2 95.2 100.0 82.9 

Workers compensation 74.1 40.0 90.0 65.5 90.5 90.6 81.7

Other cash income 59.3 80.0 92.0 58.6 90.5 93.8 80.5

Public assistance 63.0 80.0 88.0 62.1 90.5 87.5 79.3

Private pension 48.1 60.0 98.0 48.3 90.5 100.0 79.3

Supplemental Security Income—

Federal Government 66.7 40.0 90.0 65.5 85.7 87.5 79.3 

Tips and bonuses 51.9 40.0 96.0 48.3 95.2 93.8 78.0

Disability pension 59.3 40.0 92.0 58.6 90.5 87.5 78.0

Supplemental Security Income—

State-issued 59.3 20.0 90.0 55.2 90.5 84.4 75.6 

Income from estates 44.4 40.0 94.0 44.8 90.5 90.6 74.4

Income from trusts 37.0 60.0 96.0 37.9 95.2 93.8 74.4

Commissions 44.4 60.0 90.0 44.8 81.0 93.8 73.2

Welfare 48.1 40.0 88.0 44.8 85.7 87.5 72.0

Net royalties 40.7 20.0 92.0 37.9 76.2 96.9 70.7

Dividends or interest from savings 44.4 -- 92.0 37.9 85.7 90.6 70.7

Net rental income 37.0 60.0 82.0 41.4 71.4 84.4 65.9

Medical assistance 11.1 20.0 38.0 13.8 52.4 25.0 28.0

Rental assistance -- 20.0 36.0 3.4 42.9 28.1 23.2

Energy assistance 3.7 20.0 32.0 6.9 42.9 21.9 22.0

Other 14.8 -- 26.0 6.9 23.8 31.3 20.7

Source: National Survey of WIC Participants II: State and Local Agencies Report
Volume 2: State and Local Agencies (Final Report)

 x National Survey of WIC Participants II 

Most agencies (62.2%) use current income, as opposed to income from the previous year, to 

determine income-based eligibility when unemployment is not an issue. Few agencies (13.4%) 

leave this determination up to the local agencies. Current income is most often defined as that 

which is earned in the most recent 30 days or calendar month (32.9%) or shown in the latest pay 

stub/earnings statement (36.6%). 

The types of proofs of income most universally accepted (by more than 90% of State agencies) 

are pay stubs, signed statement by employer, and the most recent W-2. Also frequently cited (by 

85% to 89% of State agencies) are child support or alimony documents, court or public agency 

statement of benefits, and an officially signed unemployment letter or signed attestation of low 

income. Nearly all State agencies (97.6%) allow a signed statement of self-declaration of income 

in the absence of other proof. 

There is little variation in the certification period used for applicants who are only temporarily 

low income, such as strikers. Most State agencies (85.4%) allow the full certification period. 

Family Economic Unit 

The majority of State agencies (58.5%) report relying on the national WIC Program definition in 

determining the WIC economic/family unit and do not give any additional discretion to local 

agencies (Exhibit ES-6). More than half of States/DC agencies grant discretion to local agencies, 

compared with only one-fifth of ITOs and U.S. Territories. Large- and medium-size State agencies 

are far more likely to grant discretion than are small agencies. 

Exhibit ES-6: Additional Guidelines, if any, Given by State 

to Local WIC Agency to Determine Economic/Family Unit 

Guidelines Given 

Type of organization Number of participants 

Total

(n=82)

% 

ITO 

(n=27) 

% 

U.S. 

Territory

(n=5) 

% 

States/DC

(n=50) 

% 

Up to 

10,000 

(n=29) 

% 

10,000 to 

75,000 

(n=21) 

% 

More than 

75,000 

(n=32) 

% 

No additional discretion is given 81.5 80.0 44.0 82.8 38.1 50.0 58.5 

Discretion is given 18.5 20.0 56.0 17.2 61.9 50.0 41.5 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

A considerable proportion of State agencies either count the children in the temporary care of 

friends or relatives as part of the economic unit of the person with whom they are currently 

residing (41.5%), or count the children as a separate unit (37.8%). Only a very small minority of 

State agencies (8.5%) count absent parents and children in the temporary care of friends or 

relatives as one family unit. 
Volume 2: State and Local Agencies (Final Report)

 xi National Survey of WIC Participants II 

Adjunctive/Automatic Eligibility 

The large majority of WIC participants meet the income requirement through proven 

participation in selected other means-tested programs. The programs most frequently accepted by 

State agencies for adjunctive eligibility are the Supplemental Nutrition Assistance Program 

(SNAP) (100% of State agencies3

); Medicaid (100%); and Temporary Assistance for Needy 

Families (TANF) (98.8%).4 For automatic eligibility, the programs are Children’s Medicaid 

(46.3%), Food Distribution Program on Indian Reservations (FDPIR) (28%), and Supplemental 

Security Income (SSI) (20.7%). Some agencies also accept proven participation in the National 

School Lunch/School Breakfast programs (14.6%) and the Low-Income Home Energy 

Assistance Program (LIHEAP) (6.1%). 

Applicants must demonstrate their participation in these programs by presenting an award letter, 

an active program voucher, or other accepted proof of participation at the time of their WIC 

application. As shown in Exhibit ES-7, the most common proof provided is a program award 

letter or proof of certification, such as a program card. 

Exhibit ES-7: Percentage of Top Three Adjunctive/Automatic Eligibility 

Proofs Accepted, by Program 

Eligibility Proof Accepted 

SNAP Medicaid TANF Children’s Medicaid SSI Free and Reduced School Meal Program FDPIR LIHEAP 

Proof of certification (i.e., card) 40.2 56.1 39.0 29.3 8.5 3.7 13.4 2.4 

Program award letter 63.4 50 56.1 28 14.6 8.5 9.8 1.2 

Active program voucher 4.9 4.9 6.1 3.7 2.4 1.2 1.2 1.2 

n=82 Source: National Survey of WIC Participants II: State and Local Agencies Report 

Certification Period 

There are two areas of consideration with respect to the certification period: the certification 

period for the transition from infant to child, and the type of month (data or calendar) used. 

When an infant turns 1 year old, the majority of the agencies (56.1%) consider the infant to be 

categorically ineligible and require recertification based on criteria for a child (Exhibit ES-8). 

Slightly more than one-third of the agencies (34.1%) reported that the 6-month certification 

period remains valid for the infant who turns 1 year old. The remainder (9.8%) has no set policy 

and gives discretion to the local agency. 

 

3 The data reflects the reporting of WIC State agencies. Technically, in Puerto Rico, the Food Stamp Program was replaced by 

a block grant program, called the Nutrition Assistance Program, in 1982. The Commonwealth of the Northern Marianas Islands 

and American Samoa in the Pacific also operate under block grants that seek to provide nutrition assistance to individuals. 4 Northern Marianas reported that TANF is not applicable in their area. 
Volume 2: State and Local Agencies (Final Report)

 xii National Survey of WIC Participants II 

Exhibit ES-8: Categorical Eligibility of Infants after Turning 1 Year Old 

Type of organization Number of participants 

Total

(n=82)

% 

ITO 

(n=27) 

% 

U.S. 

Territory

(n=5) 

% 

States/DC

(n=50) 

% 

Up to 

10,000

(n=29)

% 

10,000 to

75,000 

(n=21) 

% 

More than 

75,000 

(n=32) 

% 

6-month certification period 

remains valid 22.2 40.0 40.0 17.2 42.9 43.8 34.1 

Infant becomes categorically 

ineligible and needs to again be 

certified 

74.1 40.0 48.0 75.9 38.1 50.0 56.1 

Neither: No State policy; 

discretion is given to local 

agencies 

3.7 20.0 12.0 6.9 19.0 6.3 9.8 

Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Source: National Survey of WIC Participants II: State and Local Agencies Report 

Although two-thirds of the State agencies (67.1%) use the data month for issuance cycles 

(Exhibit ES-9), only half of both ITOs and the smaller agencies do so. The vast majority of the 

State agencies (85.4%) allow full certification periods for temporary low-income persons, 

and only a small minority of the State agencies (11.0%) report shortening the certification period 

based on an anticipated income increase. States/DC agencies and the larger State agencies (above 

10,000 participants per month) are the most likely to allow a full certification period for 

temporary low-income participants (more than 90%) compared with less than three-fourths of 

ITOs and the smaller agencies. Over two-thirds of the agencies do not grant any additional 

discretion to local agencies regarding certification periods. 

Exhibit ES-9: Characteristics of Certification Periods 

Type of organization Number of participants

Total

(n=82)

% 

ITO 

(n=27) 

% 

U.S. 

Territory

(n=5) 

% 

States/

DC 

(n=50)

% 

Up to 

10,000

(n=29)

% 

10,000 

to 

75,000 

(n=21) 

% 

More 

than 

75,000 

(n=32) 

% 

Does your State use a 

data month or calendar 

month for issuance 

cycles? 

Calendar month 48.1 40.0 24.0 48.3 14.3 31.3 32.9

Data month 51.9 60.0 76.0 51.7 85.7 68.8 67.1 

For temporary lowincome persons, does 

the State allow the full 

certification period or 

shorten the 

certification period 

based on anticipated 

income increase? 

Allows full 

certification 

period 

74.1 80.0 92.0 72.4 90.5 93.8 85.4 

Shortens 

certification 

period based on 

anticipated 

income increase 

22.2 20.0 4.0 24.1 4.8 3.1 11.0 

N/A 3.7 -- 4.0 3.4 4.8 3.1 3.7
Volume 2: State and Local Agencies (Final Report)

 xiii National Survey of WIC Participants II 

Type of organization Number of participants

Total

(n=82)

% 

ITO 

(n=27) 

% 

U.S. 

Territory

(n=5) 

% 

States/

DC 

(n=50)

% 

Up to 

10,000

(n=29)

% 

10,000 

to 

75,000 

(n=21) 

% 

More 

than 

75,000 

(n=32) 

% 

What other discretion, 

if any, does the State 

use or grant to local 

agencies regarding 

certification periods? 

No additional 

discretion is given 85.2 60.0 66.0 86.2 57.1 68.8 72.0 

Other discretion 

is given 14.8 40.0 34.0 13.8 42.9 31.3 28.0 

Source: National Survey of WIC Participants II: State and Local Agencies Report

Residency Eligibility and Proof 

Most State agencies (91.5%) require applicants to present evidence that they live in the State/DC, 

ITO, or U.S. Territory in which they apply at the time of application. The ones that do not 

require proof of residency within boundaries are all ITOs. Some State agencies require applicants 

to apply to the WIC clinic that serves the local area where they live, while others may not. 

Although some local agencies have clear-cut boundaries or jurisdictions (39%), there is 

frequently overlap between local agencies’ boundaries (61%). 

State agencies were asked to report the types of identification they accept to verify residency. 

They rely heavily on such documents as utility/tax bills (92.7%) and receipts for rent, lease, 

and mortgage payments (86.6%), as proof of residency. These proofs must contain a current 

physical address, as well as the name of the applicant. Some agencies also accept written 

statements from reliable third parties (61%) and signed statements by an applicant attesting to 

being homeless or a migrant person or a victim of a loss or a disaster (72%). 

Agencies were asked how often they regularly review the records of WIC participants to identify 

duplicate certifications across local agencies. Nearly two-thirds (65.9%) of the State agencies 

reported that the process is automated and that the system constantly looks for duplicate records 

at every request for certification/recertification. The larger the State agency, the more likely it is 

to use an automated, constant review process (71.4% and 78.1% of medium and large State 

agencies, respectively) compared with less than half (48.3%) of small State agencies. 

Denials 

Most State agencies (87.8%) have a policy that requires local WIC agencies to keep information on 

denied applicants. The most frequently kept information consists of the applicant’s name (85.4%), 

reason for denial (85.4%), and date of denial (81.7%). The less frequently kept information on 

denied applicants includes date of application (72.0%) and the applicant’s address (65.9%), 

WIC applicant category (65.9%), and telephone number (62.2%). Agencies with large numbers of 

participants (more than 75,000 per month) are less likely to retain information on denied applicants 

(Exhibit ES-10). 
Volume 2: State and Local Agencies (Final Report)

 xiv National Survey of WIC Participants II 

Exhibit ES-10: Information Local Agencies Are Required to Retain on Denied Participants 

Items that must be retained 

Type of 

organization Number of participants 

Total

(n=82)

% 

ITO 

(n=27) 

% 

Territory

(n=5) 

% 

States/DC

(n=50) 

% 

Up to 

10,000 

(n=29) 

% 

10,000 to 

75,000 

(n=21) 

% 

More than 

75,000 

(n=32) 

% 

POLICY: Must keep information 

on denied applicants 85.2 100.0 88.0 89.7 90.5 84.4 87.8 

Name of applicant 81.5 100.0 86.0 86.2 90.5 81.3 85.4

Reason for denial 81.5 100.0 86.0 86.2 90.5 81.3 85.4

Date of denial 77.8 100.0 82.0 82.8 90.5 75.0 81.7

Date of application 77.8 80.0 68.0 82.8 81.0 56.3 72.0

Address of applicant 77.8 20.0 64.0 72.4 81.0 50.0 65.9

WIC category 70.4 80.0 62.0 75.9 76.2 50.0 65.9

Telephone number of applicant 70.4 20.0 62.0 65.5 81.0 46.9 62.2

Source: National Survey of WIC Participants II: State and Local Agencies Report

More than one-third of the agencies (35.4%) keep both paper and electronic copies of 

information on denied applicants, and more than one-fourth of those agencies keep either paper 

(26.8%) or electronic copies (25.6%). Most agencies (87.8%) also reported that it is State policy 

to have local agencies send an official letter of denial to applicants denied eligibility for WIC. 

Proxies 

The most frequently reported actions that designated proxies are allowed to undertake on behalf 

of the WIC participants they represent are to: pick up food instruments (95.1%), spend food 

instruments (92.7%), and attend educational sessions (81.7%). In addition, nearly half of the 

State agencies (46.3%) said they allow proxies to obtain certification for WIC applicants. 

Differences by type and size of agency are relatively modest. 

Recordkeeping and Systems 

The methods of recordkeeping and information systems differ from one State agency to the next, 

often depending on the number of WIC participants served and the technical capabilities of 

administrative offices. An overwhelming majority (85.4%) of State agencies keep current and 

previous information about participant names for over a year, with the remaining agencies 

retaining only the most current participant names. Data items that State agencies are most likely 

to keep longer than a year are the participant’s category of eligibility, food packages issued, 

clinic attended, family identity numbers, value of food packages redeemed, program through 

which the participant was adjunctively qualified, and participant’s address—retained by more 

than 80 percent of State agencies (Exhibit ES-11). Although the percentages are generally small, 

some State agencies do not retain some of the information at all. Note, however, that lack of 

retention of participant data items at the State level does not necessarily mean the data are not 

kept; rather, it could mean that these items are retained at the local agency or at the clinic level. 
Volume 2: State and Local Agencies (Final Report)

 xv National Survey of WIC Participants II 

Exhibit ES-11: Storage of Selected Data about Participants

Selected data items 

(n=82) 

State agency does 

not retain this 

information 

% 

State agency stores 

only most current 

information 

% 

State agency stores 

current and previous 

information for over a year

% 

Participant name N/A 14.6 85.4 

Clinic attended 8.5 6.1 85.4 

Family identification or affiliation 2.4 12.2 85.4 

Category of eligibility 3.7 3.7 92.7 

Participant address 2.4 15.9 81.7 

Participant telephone 2.4 18.3 79.3 

Second participant telephone number 19.5 13.4 67.1 

Food package issued 4.9 2.4 92.7 

Value of food package redeemed* 12.2 1.2 85.4 

Program through which adjunctively/ 

automatically income eligible* 6.1 8.5 84.1 

Proofs of income (if not 

adjunctively/automatically eligible)* 18.3 7.3 73.2 

Primary language 19.5 14.6 65.9 

*Not shown in table: 1.2% of State agencies responded that they retained this item for 4 to less than 12 months. 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

Agencies were also asked if proofs of eligibility were stored at the State agency level. Each of 

the five different types of eligibility documents is kept at the State level by about one-third of the 

agencies. The types of proofs and the percentages of State agencies that keep them are as follows: 

(1) Documents proving adjunctive/automatic eligibility (40.2%), 

(2) Proofs of income (36.6%), 

(3) Nutritional eligibility paperwork (35.4%), 

(4) Proof of residency (34.1%), and 

(5) Categorical eligibility paperwork (32.9%). 

Additionally, State agencies were asked whether the local agencies under their jurisdiction are 

required to keep WIC participant data as original documents, copies of original documents, an 

identifying number of original documents, or none of these items. As a general rule, original 

documents and/or copies of documents are not retained at the local agency, as shown in 

Exhibit ES-12. The one exception is for nutritional eligibility documents, which tend to be stored 

at the local agency (40.2%). The most widespread recordkeeping practice at the local agency 

level is to have a note in the records indicating that the appropriate document was shown to the 

WIC staff person. 
Volume 2: State and Local Agencies (Final Report)

 xvi National Survey of WIC Participants II 

Exhibit ES-12: Proofs of Eligibility That Local WIC Agencies Are 

Required To Keep in Their Files 

Eligibility Items 

(n=82) 

Original 

documents 

% 

Copy of 

original 

documents 

% 

Identifying 

number of 

original 

documents 

% 

A note in 

records 

indicating 

that 

document 

was shown to 

WIC staff 

% 

None of 

these items 

% 

Documents proving adjunctive/ 

automatic income eligibility 6.1 26.8 12.2 48.8 22.0 

Proofs of income eligibility 2.4 30.5 4.9 51.2 23.2 

Nutritional eligibility paperwork 40.2 14.6 1.2 26.8 25.6 

Categorical eligibility paperwork 19.5 18.3 3.7 36.6 28.0 

Proof of residency 2.4 28.0 4.9 52.4 23.2 

Note: Multiple responses were allowed, so totals do not equal 100%. 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

The interval between the time when local agencies certify a participant and when they must send 

the information to the State WIC agency is very short. Fully 41.4 percent of State agencies said 

that the data must be sent real time or daily. This is compared with 28.0 percent of State agencies 

who reported that the period is 1 month or less, and just 2.4 percent who claimed it is 31 days or 

longer. The remaining agencies (28.0%) were uncertain how long it took. 

Local Agencies 

There are approximately 2,300 local WIC agencies nationwide. A web-based survey was 

conducted to study the policies, procedures, and operations of local WIC agencies. A sample of 

587 local WIC agencies was drawn independently of the sample of agencies for the Participant 

Survey. Of the 584 local WIC agencies who received the web-based survey, 43 happened to be 

agencies where WIC participants had been sampled for the Participant Survey. A total of 

503 local agencies responded to the Local WIC Agency Survey, for a response rate of 86 percent. 

Nationally, FNS partners with the State agencies to run the WIC Program, and they, in turn, 

manage the local agencies. In attempting to capture and understand differences among agencies, 

data were analyzed according to— 

 Relationship of the local agency to the parent State WIC agency, 

 Size of the whole agency (measured by participants served per month), and 

 Number of full-time staff. 

The vast majority (95.5%) of WIC local agencies nationwide have some direct dealings with 

WIC participants, although a small number (4.5%) are administrative offices only. The latter 

group oversees clinics that, in turn, certify WIC participants and provide services, but do not 

perform the tasks themselves. 
Volume 2: State and Local Agencies (Final Report)

 xvii National Survey of WIC Participants II 

Overview 

Local WIC agencies vary greatly in size. Among the local agencies that participated in the 

survey, the number of clients served by the agency—including its clinics, satellites, and mobile 

units—ranged from 58 participants per month at a small ITO to 309,000 per month at an 

unusually large urban States/DC agency. The average number was 4,522 (median = 4,307) 

participants served per month by the whole agency. 

For the most part, local agencies provide similar capabilities to one another and more than 90 

percent are well equipped to conduct certifications, provide nutrition counseling and referrals for 

services, take anthropometric measures, access data electronically, and distribute food vouchers. 

Clinics are similarly well equipped. Breastfeeding and nutrition services are nearly universal. 

Nearly all local agencies enter and access information electronically, with 93 percent having 

Internet access. 

Organizationally, the greatest number of local WIC agencies (44.6% total) said they are 

administered by a local government entity (41.9%) or, occasionally, as a clinic under a local 

agency (2.7%). Others are managed as part of the State WIC agency (29.3%) or by 

nongovernmental organizations (NGOs) (26.2%), including non-profit organizations, hospitals, 

health centers, and universities (Exhibit ES-13). These three groups are referred to as Stateaffiliated agencies, local government agencies, and non-government agencies in this report. 

The majority of local agencies (84.2%) have clinics; a sizeable number of them also have 

satellites (31.6%); and very few have mobile units (2.6%). 

Exhibit ES-13: Organizational Relationship of Local Agency to State Agency 

Part of State agency

29.3 %

Non-government 

organization

26.2 %

Local government

entity 

41.9% Local

government

44.6%

WIC clinic

2.7%

n=503 

Source: National Survey of WIC Participants II: State and Local Agencies Report 
Volume 2: State and Local Agencies (Final Report)

 xviii National Survey of WIC Participants II 

Characteristics of Local WIC Agencies 

There are substantial differences in size (participants) among the three types of local agencies: 

State-affiliated versus local government versus non-government. Non-government and local 

government agencies are, on average, substantially bigger than State-affiliated agencies (Exhibit 

ES-14). 

Exhibit ES-14: Relationship of Local WIC Agency to State Agency, by Participants Served 

Organizational relationship of local agency to State WIC agency 

State-affiliated 

(n=136) 

Local government 

(n=219) 

Non-government 

(n=148) 

Average number of participants served 

per month by whole local agency 1,555 3,071 3,753 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

Overall, the main sites of the local agencies seem well equipped: Over 90 percent are able to 

conduct certifications and nutrition counseling, provide referrals for other services, take 

anthropometric measurements, access WIC participant data electronically, and distribute food 

checks. Most agencies can also perform blood testing and offer educational seminars. A look at 

the capabilities of local agencies’ clinic, satellite, and mobile unit operations shows that they, too, 

are usually well equipped (Exhibit ES-15). Clinics, especially, have services almost at the same 

level as the main site, with an average of 90 percent offering all services, while satellites and 

mobile units are close behind in all areas except in performing certifications and nutrition education. 
Volume 2: State and Local Agencies (Final Report)

 xix National Survey of WIC Participants II 

Exhibit ES-15: Capabilities of Clinics, Satellites, and Mobile Units 

84.9

90.7

90.3

57.6

69.9

85.5

80.2

85.4

91.0

87.2

92.1

88.8

84.2

84.8

91.0

92.2

95.6

94.7

84.9

86.1

92.0

82.4

96.4

91.7

69.0

50.1

89.9

2.1

6.0

4.5

11.4

20.4

11.2

2.1

4.7

2.5

7.8

4.2

6.2

4.7

8.0

6.4

2.3

0.6

2.6

2.1

10.6

4.7

7.8

1.8

3.3

2.8

19.8

5.4

12.9

3.3

5.2

31.0

9.6

3.3

17.6

9.9

6.4

5.1

3.7

5.0

11.1

7.2

2.6

5.5

3.8

2.7

12.9

3.3

3.2

9.8

1.7

5.0

28.1

30.1

4.7

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Mobile

Satellites

Clinics

Mobile

Satellites

Clinics

Mobile

Satellites

Clinics

Mobile

Satellites

Clinics

Mobile

Satellites

Clinics

Mobile

Satellites

Clinics

Mobile

Satellites

Clinics

Mobile

Satellites

Clinics

Mobile

Satellites

Clinics

Paper

copies Education Blood

Food

checks

Elec.

records

Anthropometric Referrals Nutrition counseling Certifi- cations

Percentage 1 Percentage saying all of units have this capability

2 Percentage saying some of units have this capability

3 Percentage saying none of units have this capability

n=503 Source: National Survey of WIC Participants II: State and Local Agencies Report 
Volume 2: State and Local Agencies (Final Report)

 xx National Survey of WIC Participants II 

Local agencies were asked to describe the typical profile of the WIC participants they serve each 

month and provide percentage estimates of their population by category, ethnicity, race, migrant 

status, and homelessness. They reported that the overall population of participants was composed 

of mostly children (48.5%) and infants (23.1%), with women constituting a minority of cases 

(12.8% pregnant, 9.0% postpartum, and 6.7% breastfeeding) (Exhibit ES-16). These proportions 

are consistent with national figures and the findings of the Participant Characteristics report. 

There were no differences in type of participants by agency characteristics and, indeed, type or 

size of agency has no relationship to the type of participants. 

Exhibit ES-16: Profile of Local Agency Participants, by Category, 

as Reported by Agency 

n=503 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

Staff and Caseload 

Staffing information collected from agencies included the number of full-time staff by position, 

the number of part-time staff, the number of staff who had worked at the agency less than 2 years, 

and an estimate of total full-time equivalent (FTE) staff. On average, local agencies employ 

17.9 FTE staff members. Not surprisingly, the larger the agency, the larger the staff. 

The majority of local agencies (52.6%) have some degree of staffing shortage. Registered dietitians, 

administrative support, nutritionists, nurses, and physician assistants are the professionals for 

whom there is the greatest need. Larger agencies (serving 4,500 participants a month or more) and 

those that are State-affiliated exhibit a higher degree of staffing shortage than do other agencies. 

More than three-quarters of the local agencies (78.2%) reported having difficulties retaining, 

recruiting, and hiring staff. 

The top three hiring challenges for agencies pertain to limited salaries (54.0%), limited career 

opportunities (40.4%), and heavy workloads (23.5%). 

12.8%

6.7%

9.0%

23.1%

48.5%

Pregnant

Breastfeeding

Postpartum

Infants

Children
Volume 2: State and Local Agencies (Final Report)

 xxi National Survey of WIC Participants II 

Main Local Agency Site 

Data were gathered on the physical facility and operational details at the primary site of each 

local agency. Such factors all play an important role in how the WIC Program operations are 

carried out and how well participants’ needs are met. 

Almost three-fourths of local agencies’ main sites (73.6%) are located in health departments, 

health clinics, or health centers. In contrast, few are located in social service agencies (7.1%), 

hospitals (6.3%), or non-profit organizations (13.1%). On average, the main sites of the local 

agencies are open 5 days per week, for a total of 36 hours; the smaller agencies 

(<750 participants per month) reported just 4 days and a total of 31 hours per week on average. 

As a whole, local agencies estimate they serve an average of 2,805 participants per month at their 

main site, which increases with agency size. 

Local agencies were asked about their computer infrastructure at the main agency site and their 

ability to perform certain basic medical assessments requiring specialized equipment. Virtually 

all local agencies (98.2%) reported having the ability to enter and access participant information 

via computers for certifications, and (93.7%) reported having Internet access. The smaller 

agencies were the least likely to have Internet access (90.1%), while the larger agencies were the 

most likely (97.8%). 

A very high number of the agencies (96.9%) believe that their location is “safe” or “very safe.” 

About 5.8% of large local agencies feel their agency is “unsafe” or “very unsafe.” 

Just over half of all agencies (55.6%) have public transportation within a 10-minute walk 

or 1/2-mile distance of their location. The larger the agency, the more likely it is to be near bus 

or light rail transportation. The overwhelming majority of agencies (91.8%) reported that 

participants are using private cars as the most frequent mode of transportation, followed by 

walking (46.2%). 

Participant Services at Main Local Agency Site 

On an aided basis, local agencies were asked if their main location provided nutrition services in 

19 specific areas—from breastfeeding support to family planning to employment/life skills training. 

To capture the extent of the services provided, agencies were asked whether the service was 

offered by the WIC agency/clinic itself, whether the agency can provide information on the topic, 

or whether the agency can make a referral. 

Of all the services offered by the local WIC agency itself, breastfeeding support was the most 

frequently offered (96.7%), followed by nutrition services (91.2%), prevention and screenings 

(e.g. immunizations) (62.7%), sexually transmitted diseases (STD) services (46.0%), and family 

planning (44.6%) (Exhibit ES-17). Less frequently offered services include children’s health care, 

environmental health/screening, maternal health care, smoking cessation, prenatal health care, 

dental services, and parenting support, all of which were directly offered by less than one-third 

of all agencies. 
Volume 2: State and Local Agencies (Final Report)

 xxii National Survey of WIC Participants II 

Exhibit ES-17: Local WIC Agency: Services Most Frequently 

Offered Directly by WIC Agency 

Services provided 

Total 

(n=503) 

% 

Breastfeeding support 96.7 

Dietitian/nutrition services 91.2 

Prevention and screenings 62.7 

Sexually transmitted diseases 46.0 

Family planning 44.6 

Total 2,291 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

If a local agency stated that it gives out a referral for any service, a follow-up question was asked 

to clarify what this involved. Specifically, local agencies were asked if they were able to give out 

direct referrals for services, provide the name of an appropriate outside organization, or notify an 

outside organization of a situation. 

Providing participants a direct referral to services was, overall, the most prevalent type of referral. 

For all the 19 services listed, a large majority of local agencies provided referrals, with the 

exception of violence protection/prevention for women and children. 

Nutrition Education 

Nutrition education and counseling services are the cornerstones of the WIC Program. Together, 

they seek to teach the connection between nutrition, physical activity and health and to promote 

the adoption of positive dietary and physical habits. Key services that the WIC Program 

provides are nutrition education, breastfeeding promotion and support, and preventive measures, 

such as health care referrals. The method for delivering these services differs between State 

agencies and even, sometimes, among local agencies under the same State agency. 

Of the different forms of nutrition education offered to WIC participants, the most universal is oneon-one counseling, which is conducted at all local agencies (99.5%), as shown in Exhibit ES-18. 

The next most prevalent are group sessions (74.6%) and web-based programs (31.5%). A small 

percentage offers other means (11.0%), which include educational kiosks, interactive displays, 

posters, and handouts. 
Volume 2: State and Local Agencies (Final Report)

 xxiii National Survey of WIC Participants II 

Exhibit ES-18: Types of Nutrition Education Services 

n=503 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

As shown in Exhibit ES-19, registered dietitians are the most likely to conduct the nutrition 

education (81.6% of agencies), but nutritionists with degrees or licenses, WIC directors or clinic 

supervisors, registered nurses/physician assistants, and trained nutrition paraprofessionals also 

participate in this activity in approximately half or more of the local agencies. 

Exhibit ES-19: Nutrition Counseling Services Offered, by Type of Staff (% of agencies) 

n=503 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

31.5

74.6

99.5

0% 20% 40% 60% 80% 100%

Internet-based nutrition education

Group educational sessions

One-on-one counseling

Percentage

10.3

14.0

32.4

46.8

50.6

52.1

62.5

81.6

0% 20% 40% 60% 80% 100%

Other health professionals not listed here

Administrative/clerical/support staff

Peer counselors

Trained nutrition paraprofessional

Registered nurses/physicians assistants

WIC director or clinic supervisor

Degreed/licensed nutritionists

Registered dietitians

Percentage
Volume 2: State and Local Agencies (Final Report)

 xxiv National Survey of WIC Participants II 

Local WIC agencies are required to provide nutrition education services at the time of initial 

certification and during follow-up visits. Although participants are not required to attend these 

sessions, they are strongly encouraged to do so. The majority (56.0%) of agencies provide 

10–19 minutes of nutrition education/counseling during the initial visit. 

Agency Procedures 

In most agencies (94.0%), the certification of the applicant must occur in person. More than 

80.0 percent of all agencies grant temporary certification to 10 percent or fewer of their 

applicants. The use of temporary certification shows how well prepared applicants are at the time 

of application; it also shows how flexible the local agency is in extending an initial period 

of eligibility. 

Proxies are allowed in most jurisdictions, but what they are allowed to do varies. The most 

universal functions permitted are picking up food instruments (97.7%) and attending educational 

sessions (80.7%). Only 44.2 percent allow proxies to apply for certification and even fewer 

(17.3%) allow proxies to redeem food checks at stores. In a small number of States (2.4%), 

proxies are not allowed to perform any role. 

Applicants for participation in the WIC Program can be denied certification based on several 

factors, including lack of sufficient identification documentation at the time of application; 

excessive household income; lack of need based on nutritional standards; incorrect residential 

location, and/or lack of categorical eligibility (e.g., child over 5 years). The criteria 

notwithstanding, only a small proportion of new and recertifying applicants are denied 

certification (Exhibit ES-20), amounting to 10 percent or less at almost all agencies. 

Exhibit ES-20: Average Denial Rates at Local WIC Agencies 

Average percentage of 

applicants/participants denied 

WIC 

% 

Percent of local agencies 

% 

(n=503) 

Applicants denied new certification ≤10 96.4 

11–20 2.6 

21–30 0.5 

31–100 0.5 

Total 100.0 

Participants denied recertification ≤10 96.6 

11–20 2.6 

21–100 0.8 

Total 100.0 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

Approximately half of the agencies (52.3%) allow screening and denial by telephone. Of those 

agencies that allow screening this way, the greatest number use it to determine income eligibility 

(97.5%), followed by category eligibility (68.6%), and residential eligibility (52.5%). Not many 

use it to determine if identification or nutritional proofs are sufficient (8.1% and 3.0%, 

respectively). A total of 84.1 percent of all local agencies retain information about denied 
Volume 2: State and Local Agencies (Final Report)

 xxv National Survey of WIC Participants II 

applications. Typical information retained consists of applicant’s name, address, and telephone 

number. 

Local agencies list multiple measures in place to avoid duplicate participation, with a computer 

check based on applicant information being the most prevalent (82.5%). Three-fourths of the 

agencies require the applicant to show identification, while an equal number require proof of 

current residence. Other procedures cited tend to deal with some variation of computer-generated 

matches on such items as applicant’s name, gender, date of birth, Social Security number, and/or 

WIC status. 

Proof of residency is an important component in the process of determining an applicant’s 

eligibility for WIC benefits and in controlling for duplicate participation. Local agencies tend to 

rely heavily on utility receipt, tax bill, rent receipt, lease, and mortgage receipt as proof of 

identity, as shown in Exhibit ES-21. In contrast, few agencies rely on income or benefits 

documents such as pay stubs, pay checks, Social Security Income checks, unemployment checks, 

Medicaid cards, or health insurance cards. 

Exhibit ES-21: Types of Residency Proof Accepted 

n=503 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

32.8

11.1

15.3

16.0

32.8

64.0

72.3

91.6

97.6

0% 20% 40% 60% 80% 100%

Other

Pay stub, pay check, SSI check, unemployment 

check 

Other mail with name and address on it

Medicaid or health insurance card

Checkbook, bank statement

Written statement from reliable third party

Drivers license, State ID

Rent receipt, mortgage receipt, or lease

Current utility/tax bill with address on it

Percentage
 1 National Survey of WIC Participants II 

CHAPTER 1. OVERVIEW OF THE WIC PROGRAM AND 

PROGRAM ELIGIBILITY

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is the 

United States Department of Agriculture’s (USDA) third largest food and nutrition assistance 

program. In existence for over 35 years, the WIC Program provides benefits to low-income, 

pregnant, and new mothers and their young children who are at nutritional risk. The benefits 

consist of nutritious supplemental foods, nutrition education, and referrals to health care and 

social services. The WIC Program is funded by USDA’s Food and Nutrition Service (FNS), 

which administers the program in partnership with State and local agencies. Although research 

on the effectiveness of WIC has often been narrow in scope (thus reducing its generalizability)5

and some of it is dated, the WIC Program is still widely credited for increasing access to prenatal 

care, 6 improving birth outcomes,7 , 8 reducing the incidence of anemia, 9 and enhancing the 

nutritional quality of participants’ diets.10

Expansion of the program has been dramatic, with the number of participants increasing from 

88,000 per month in 197411 to over 9 million per month in 2010. Today over half of all infants 

and about one-quarter of children under 5 years old participate in the program. Current program 

emphases include promoting food security, healthy eating and weight, and breastfeeding. 12

Recently, the WIC Program rolled out new food packages, which were fully implemented in all 

State agencies by October 2009. Reflecting the first significant revisions since 1980, the 

packages are designed to promote greater health by offering fruits and vegetables, as well as 

foods that have more fiber and less fat and cholesterol. In addition, foods allocated for 

breastfeeding mothers and infants have been increased to promote breastfeeding more strongly as 

the healthiest nourishment for infants. 

To qualify for WIC benefits, applicants must meet categorical, 13 residential, income, 14 and 

nutritional eligibility requirements. WIC participants are eligible to receive benefits for specified 

periods, after which they must be recertified in order to continue receiving benefits. 

 

5 U.S. Department of Agriculture, Economic Research Service. (2009). The WIC Program: Background, trends, and economic issues.

Retrieved from http://www.ers.usda.gov/publications/err73/ 

6 Devaney, B., Bilheimer, L., et al. (1992). Medicaid costs and birth outcomes: The effects of prenatal WIC participation and the 

use of prenatal care. Journal of Policy Analysis and Management, 11(4) Autumn, 573–592. 7 Moss, N., & Carver, K. (1998). The effect of WIC and Medicaid on infant mortality in the United States. American Journal of 

Public Health, 88, 1354–1361. 8 Buescher P., Larson L., et al. (1993). Prenatal WIC participation can reduce low birth weight and newborn medical costs: 

A cost benefits analysis of WIC participation in North Carolina. Journal of the American Dietetic Association, 93, 163–166. 9 Miller, V., Swaney, S., et al. (1985). Impact of the WIC Program on the iron status of infants. Pediatrics, 75(1), January, 100–105. 10 Siega-Riz, A., Kranz, S., et al. (2004). The effect of participation in the WIC Program on preschoolers’ diets. The Journal of 

Pediatrics, 144(2, February), 229–234. 11 Oliveira, V., Racine, E., Olmsted, et al. The WIC Program: Background, trends, and issues, 11. Retrieved from 

http://www.ersusda.gov/publications/fanrr27/fanrr27c.pdf 

12 U.S. Department of Agriculture. (2008). Annual Performance Report 2008. Retrieved from 

http://www.ocfo.usda.gov/usdarpt/par2008/pdf/005_2k8_USDA_PAR_APR.pdf 13 That is, be a pregnant, breastfeeding, or postpartum mother (within certain parameters), an infant up to 1 year of age, or a 

child up to 5 years of age. 

14 Income requirements can be met by demonstrating “adjunctive eligibility” through participation in other specified 

needs-based programs such as Medicaid, SNAP, and TANF. 
Volume 2: State and Local Agencies (Final Report)

 2 National Survey of WIC Participants II 

The WIC Legislative Requirements are contained in Section 17 of the Child Nutrition Act of 

1966, as amended. The WIC regulations, with which State and local WIC agencies must comply, 

are published in the Federal Register in the Code of Federal Regulations (CFR), 7 C.F.R. Part 

246. The CFR is updated on January 1 of each year. In some matters—for example, nutritional 

risk priorities—the WIC regulations are very explicit and give little leeway. However, in many 

areas—for example, the list of low-income programs that will allow applicants to qualify 

automatically—FNS gives a fair amount of discretion to the State agencies. 

1.1 Goals of the Study 

This study, the Second National Survey of WIC Participants (NSWP-II), was started in the 

summer of 2007. It set out to accomplish the following goals: 

1. Explore the characteristics and experiences of WIC participants; 

2. Provide information on the policies, procedures, operations, and staff of State and local 

WIC agencies; 

3. Estimate the annual cost of erroneous payments in the program; and 

4. Develop a model for updating estimates of erroneous payments for the next 10 years. 

The study is a follow-up to the first National Survey of WIC Participants (NSWP-I), for which 

data were collected in 1998 and a report was issued in 2001. For NSWP-I, as for NSWP-II, FNS 

collected demographic information on WIC participants and their households, and developed 

national estimates of the case error rate and dollar error within the WIC Program. 

In the 10 years since the NSWP-I report was published, FNS has conducted numerous other studies 

on WIC that are related to program activities, participation patterns, WIC food cost containment 

practices, diet of participating children compared with that of other children, breastfeeding 

intervention, vendor characteristics and management practices, WIC improper payments estimation, 

and analysis of food packages, among other topics. 

One consistent source of information is the biennial data that FNS has collected from WIC State 

management information systems since 1992—the WIC Participant and Program Characteristics 

series. A virtual census of all WIC participants, the items reported in that study include 

participants’ category, age, and race; basic anthropomorphic measures; participants’ nutritional risk; 

their income and migrant status; and their participation in Temporary Assistance for Needy 

Families (TANF), Medicaid, and/or the Supplemental Nutrition Assistance Program (SNAP). 

Starting in 1998, data for the WIC Participants study expanded to include breastfeeding status and 

food package prescriptions. Many State data systems have also been able to report health care, 

education, number of people in the household on WIC, and birth weight.15,16,17

 

15 U.S. Department of Agriculture, Food and Nutrition Service, Office of Analysis, Nutrition and Evaluation, Food and Nutrition 

Service. (2006, March). WIC participant and program characteristics 2004: Summary. Retrieved from 

http://www.abtassociates.com/reports/ESwicpartpc2004.pdf 

16 U.S. Department of Agriculture, Food and Nutrition Service. (2010). Guidance for states providing participant data study of WIC 

participant and program characteristics 2010: PC2010. Retrieved from http://www.fns.usda.gov/wic/PC2010Guidance.pdf 
Volume 2: State and Local Agencies (Final Report)

 3 National Survey of WIC Participants II 

NSWP-II aims to add to the current body of WIC knowledge by providing updated information 

on participants’ satisfaction and use of WIC services, and collecting data not covered by the 

other studies—especially in the area of State and local WIC agencies operations. 

Most importantly, it also fulfills the requirements of the 2002 Improper Payments Information Act. 

This law and subsequent Office of Management and Budget and executive directives18 stipulate 

that agencies must review all programs and activities and identify significant erroneous payments, 

defined as annual payment errors exceeding both 2.5 percent of program payments and $10 million. 

This volume addresses the second goal of the Study—providing information on the policies, 

procedures, operations, and staff at State and local WIC agencies. The other goals will be covered 

in three additional, separate reports. 

The volume starts with an Executive Summary (Chapter 2) and then discusses research 

approaches used in the two data collections among State and local WIC agencies The findings 

are presented separately, with the characteristics of State WIC agencies presented first (Chapter 

3), followed by the characteristics of local WIC agencies (Chapter 4). 

In addition, the report includes supplemental information consisting of survey instruments and 

additional tables in the appendices. 

 17 U.S. Department of Agriculture, Food and Nutrition Service. (Modified May 22, 2010). WIC participant and program 

characteristics 2002: Summary and highlights. Retrieved from 

http://www.fns.usda.gov/ora/menu/Published/WIC/FILES/PC2002.htm 

18 Federal Register, Executive Order 13520 of November 20, 2009. (2009). Retrieved from 

http://www.whitehouse.gov/omb/assets/financial_improper/11202009_improper_payments.pdf 
 4 National Survey of WIC Participants II 

CHAPTER 2. THE STUDY METHODOLOGY

2.1 Source of Data 

Two surveys were designed to study the policies, procedures, operations, and staff of State WIC 

agencies. 19 These surveys consisted of (1) a census of all 90 State agencies including 

50 States/DC, 5 U.S. Territories, and 34 Indian Tribal Organizations (ITOs); and (2) a sample of 

587 local WIC agencies representing all State agencies, drawn from the approximately 2,300 

local agencies nationwide. 

The State agency census was estimated to take about 66 minutes to complete, and all the State 

agencies were supposed to comply. However, responses were received from only 82 State 

agencies (91% response rate) comprised of 50 States/DC, 27 ITOs, and 5 U.S. Territories. 

Because of the relatively modest number of State agencies overall, a paper-and-pencil survey 

was used. It was sent both by mail and by e-mail (as an attachment). State agencies first received 

a letter from the WIC director urging their participation before the survey was mailed to them. 

As individual circumstances dictated, each State agency director was contacted via e-mail, then 

via telephone until the State agency responded. Extensive follow-up procedures were used, 

which involved as many as 10 contacts by telephone and email from the NSWP-II Project 

Director and Deputy Director. In one case the FNS regional office was asked to help gain the 

cooperation of a State agency. Extensions were given to over a dozen State agencies needing 

more time. These efforts notwithstanding, seven ITOs did not return the survey. And one State 

refused to participate even after direct follow-up requests from FNS. 

The local agency sample was drawn from a list of local agencies provided by the State agencies, 

with monthly participant data listed by category for the sample period in spring 2009. 

This yielded a sample frame of 2,300 local agencies, a bit more than national WIC program 

reports of about 2,000 to 2,200 local agencies. 20 This may be because of the structure of a few 

State organizations where there is no clear distinction between local agencies and clinics, and 

clinics may report directly to the State agency. Thus, such State agencies reported more local 

agencies than normal. However, since the sample was based on the size of the organization 

(in terms of participants served), the weighting that was applied ensured an accurate profile of 

local agencies and their policies. From the list, a sample of 587 was selected in anticipation of 

receiving 500 responses. The WIC region variable, available from the dataset, was used to adjust 

the weights to account for non-responding agencies. 

The agencies were invited to participate in a web survey estimated to take about 40 minutes, 

using e-mail addresses obtained from State agency directors. A customized link to a URL with 

an embedded password was included in each e-mail. Letters were sent to the agencies where 

e-mail was not available, which also included the link information. Seven agencies filled out the 

survey on paper and mailed it in. Responses were received from local agencies in all State 

agencies, except one, which refused to permit its agencies to accept the survey. Additional e-mail 

follow-up was made to local agencies that did not respond. Ultimately, State agency directors 

 

19 The term “State agencies” will be used to refer collectively to all State, District of Columbia, U.S. Territory, and ITO agencies. 20 Victor Oliveira, V., & Frazão, E. U.S. Department of Agriculture, Food and Nutrition Service, U.S. Department of Agriculture. 

(2009). The WIC Program: Background, trends and economic issues. Retrieved from 

http://www.ers.usda.gov/publications/err73/err73.pdf 
Volume 2: State and Local Agencies (Final Report)

 5 National Survey of WIC Participants II 

were engaged to assist in urging local agencies to respond. This combination of approaches 

yielded 503 completed local agency surveys, yielding a response rate of 86 percent. 

Although a vast majority (95.5%) of WIC local agencies nationwide have direct dealings with 

WIC participants, a small number (4.5%) are just administrative offices. This means that they 

oversee clinics that, in turn, certify WIC participants and provide services but do not provide 

those services themselves. Since a large number of the Local WIC Agency Survey questions 

dealt with the characteristics of the primary WIC agency site—including the building, hours of 

operation, safety of site, participant services offered, and agency procedures dealing with 

participants—agencies that were purely administrative were asked to answer the primary site 

questions, by selecting and providing answers for a “typical” clinic under their purview. 

2.2 Survey Content 

State Policies and Procedures 

Within the Federal guidelines, State WIC agencies have considerable authority over WIC 

Program operations, including defining eligibility criteria, negotiating food prices, specifying 

application and payment procedures, and establishing program data management. State WIC 

agencies also have discretion over many important issues including— 

 Household income calculation (including adjunctive and automatic income eligibility); 

 Definition of household unit, for circumstances not addressed by Federal guidance; 

 Calculating family unit income for households with separate economic units; 

 Establishing sources of income that must be considered and the time period established 

for income eligibility (e.g., current, including definition of current, last year, other); 

 Acceptable proofs of income; 

 Policies regarding self-declaration; 

 Treatment of temporary low income; and 

 Temporary care of children. 

States may also differ in— 

 Certification periods for infants; 

 Issuance cycles for food vouchers; 

 Residency requirements and acceptable proofs of residency; 

 Determination of nutritional eligibility; 

 Recordkeeping requirements; 

 Length of time food vouchers can be used; and 

 Discretion granted to local agencies, if permitted. 
Volume 2: State and Local Agencies (Final Report)

 6 National Survey of WIC Participants II 

Additional areas of consideration are the actions proxies may take on behalf of participants, 

distribution of food vouchers, and promotion of breastfeeding. 

Information on all of these topics was obtained through the State WIC Agency Survey. 

While State WIC agencies have typically had—and continue to use—considerable discretion in 

the administration of their programs where permitted by FNS, common statewide systems seem 

to leave less leeway to local agencies. The findings of this study describe the extent to which 

these discretions are exercised and restrictions are applied. Data are presented for the total as 

well as for selected breakdowns in terms of organizational control and size. 

Local Agency Policies and Operations 

The Local WIC Agency Survey focused on areas related to the services offered to WIC 

participants as well as procedures followed by the local agency in providing WIC services to 

participants. As such, the report covered the following specific areas: 

 Organization of agency (structure, clinics, sites under the local agency); 

 Procedures used to determine eligibility; 

 Certification and recertification policies and approaches; 

 Distribution of food vouchers; 

 Information gathered from applicants (including denied applicants), and how it is handled 

and stored; 

 Staff qualifications and participant caseloads; 

 Range of services offered (health care, family planning, smoking cessation) and referrals; 

 Nutrition education services offered (topics, providers, time allocated); 

 Hours of operation, location, space, and equipment onsite; 

 Distribution of Nutrition Services and Administration (NSA) funds; and 

 Demographics of participants served. 

2.3 Sample Design 

Sampling of Local WIC Agencies 

A national sample of 587 local agencies was drawn for conducting the survey on the characteristics 

of local WIC agencies. The target sample size was 500 agencies, independent of the local agencies 

selected for the Participant Survey. The discussion of the sampling process covers the reasoning 

for the sample size, the creation of the national local agency frame, the calculation of the local 

agencies’ measure of size (MOS), probabilities of selection, and the sampling procedure. 
Volume 2: State and Local Agencies (Final Report)

 7 National Survey of WIC Participants II 

Sample Size 

The parameters of the study required a national sample of 500 agencies at a precision of 

95 percent confidence interval, ± 4.5 percent for estimates of 50 percent. 

Accounting for non-response and assuming an 80 percent response rate, a sample of 587 local 

WIC agencies was drawn independently of the sample of agencies for the Participant Survey. 

Of the 584 local WIC agencies who received the survey (16 in Minnesota did not because of the 

State’s lack of participation), 43 were also sampled for the Participant Survey. A total of 

503 local agencies responded to the Local WIC Agency Survey, for a response rate of 86 percent, 

based on actual survey recipients. 

The Sampling Frame for the National Sample of Local Agencies 

Before drawing the national sample for the Local WIC Agency Survey, 23 States/DC had 

already provided their lists of local agencies. The data included the number of participants in 

each agency by program category: pregnant, breastfeeding, postpartum, infants, and children. 

Lists of local agencies, including the number of WIC participants in each of the five categories, 

were obtained for the remaining State WIC agencies to complete the sampling frame. 

Selection of the Local Agency Sample 

The local agency sample was selected using probability proportional to size (PPS) without 

replacement.21 The use of sampling without replacement meant that the larger local agencies 

were likely to be selected as certainties. That means their probability of selection was greater 

than 1 and therefore set equal to 1. This was done so that 587 distinct local WIC agencies would 

be sampled nationwide. 

In order to sample proportional to size, a local agency measure of size (MOS) had to be calculated. 

By calculating the MOS for local agencies, some consistency in MOS between this sample and the 

WIC Participant Survey sample design was necessary. To achieve this, the following formula was 

used to calculate the size of the local agency (LA): 

 ൌ  

∑ 

∑ 

൅ ∑ 

∑ 

൅ ∑ 

∑ 

൅ ∑ 

∑ 

൅ ∑ 

∑ 

5

Where— P = Pregnant, 

 B = Breastfeeding, 

 N = Postpartum Non-breastfeeding, 

 I = Infants, and 

 C = Children 

—constitute the five categories of WIC participants. 

 

21 Probability Proportionate to Size is the method proposed by Goodman and Kish in 1950. 
Volume 2: State and Local Agencies (Final Report)

 8 National Survey of WIC Participants II 

In short, the probability of sample selection for each local agency was determined by the sum of 

five ratios—each representing a participant category served at the agency, relative to its 

representation in the national population—divided by five. 

Secondly, with respect to the types of estimates produced using the sample, the two following 

considerations were important: (1) the survey may be used to estimate the percentage of local 

agencies that provide a certain type of service, or (2) it may be used to estimate the percentage of 

participants who receive certain benefits. To achieve both types of estimates, the square root of 

the LA size was used and sampling was done proportional to the adjusted MOS.22

Sampling Procedure 

Using the square root of the size of each LA, the local agencies’ probability of selection was 

calculated as follows: 

LA Probj = LA Size1⁄2 x ( 600 –i )

 ∑ LA Size1⁄2 

 

Where— i = the number of certainty agencies and 

j = the number of iterations until all certainties were determined 

A certainty local agency is defined as an agency where LAProbj > 1. By its nature, the process of 

calculating the local agency probability becomes iterative. In the first run, i = 0; in the second 

run, i = number of certainties from the first run. This continues until LAProbj ≤ 0 for all the 

remaining noncertainty local agencies. There were 27 certainty local agencies, and the process 

took 4 iterations. The sampling frame was then sorted randomly within WIC regions and State 

WIC agencies, and a PPS sample was drawn. 

Weighting 

Each local agency was sampled with PPS, using a size measure that was the square root of the 

average of the proportion of participants in each of the five categories. This size measure was 

then used to calculate the local agency’s probability of selection and its inverse was used as the 

initial local agency weight. Then the responding local agencies’ weights were adjusted to 

account for the non-responding agencies. The final weight was the non-response adjusted weight, 

which is an estimate of the total number of local WIC agencies nationwide. 

 

22 Saavedra, P. J., & Heimowitz, H. (2004, August). Sample selection by powers of size when needing estimates at multiple levels.

Proceedings of the Joint Statistical Meetings. American Statistical Association, Toronto, Canada. 
Volume 2: State and Local Agencies (Final Report)

 9 National Survey of WIC Participants II 

Where—r = the responding agencies

 n = the total number of sampled agencies 

 k = the region 

2.4 Analysis 

State data are derived from a census. Thus, sampling adjustments, weighting, and tests of 

significance are not applicable. Statements about differences by type and size of an agency are 

interpretations based on apparent policy implication.

The term “local agency” was defined by the State agency, and hence is somewhat arbitrary. For 

example, the most common arrangement is to have a State WIC agency that oversees some 

number of local WIC agencies, each of which, in turn, oversees a number of local clinics. They 

also certify and provide services to WIC participants. However, in some cases, local agencies 

only perform an administrative role (i.e. providing no direct services). In other instances—

particularly in small ITO’s and Puerto Rico—the local agencies are the same as local clinics, 

there being no middle layer of agency. In instances where a local agency provided no direct 

services, the agency was asked to fill out the section on the facility and services based on a 

“typical” clinic under their purview. 

Local agency responses were uniformly weighted throughout the report, following the 

methodology explained in the previous section, to reflect a measure of agency size. Generally, 

data is reported as percentages although means are also shown where appropriate. Appendix D 

presents a more detailed breakdown of data, including the standard deviation for means as well 

as significance tests for differences between groups.23 

 

23 The latter are presented with a strong caveat. Where the number of comparisons is very large, and 5 percent can be 

expected to be significant by chance, the significance tests must be regarded as merely suggestive. In some cases, the statistics 

for chi-square cannot be computed because of empty cells. Finally, significance is determined by both the strength of the 

relationship and the effective sample size, which is a function of both the actual sample size and the sample design; it may be

different for different comparisons. 
 10 National Survey of WIC Participants II 

CHAPTER 3. STATE WIC AGENCY FINDINGS

3.1 Size and Organization of State Agency 

There are 90 State WIC agencies nationwide: the 50 States/DC, 34 Indian Tribal Organizations 

(ITOs), and 5 U.S. Territories (Puerto Rico, American Samoa, Guam, the Commonwealth 

Islands of the Northern Marianas, and the Virgin Islands). Working in partnership with FNS, 

they have the formidable responsibility of overseeing a national network of about 2,300 local 

agencies and 9,000 clinics that currently provide food and services to over 9 million WIC 

participants each month. Although these agencies are technically part of territorial, 

commonwealth, tribal, Federal district, and State governments; this report will refer to them 

collectively as “State WIC agencies,” in keeping with FNS practice. 

Overall, 82 of the 90 State WIC agencies participated in the study, making the results a near census. 

Since FNS’ biennial WIC Program and Participants Characteristics Report gathers data about the 

demographic and nutritional profile of WIC participants at the State agency level, this report 

focuses on agency policies and operations. As noted earlier, FNS defers to State WIC agencies’ 

discretionary powers of implementing many of the regulations; so it is particularly important to 

understand how various regulations are interpreted and implemented. The survey was designed to 

gather specific information about recertification practices, the fulfillment of eligibility 

requirements, definitions of key program items, document retention and recordkeeping, 

distribution of food instruments, and some general agency profile information. 

The size and complexity of State WIC agencies vary considerably. California, with the largest 

WIC population of more than 1.4 million participants per month, has 82 local agencies. On the 

other end of the spectrum, several ITO State agencies serve fewer than 200 WIC participants per 

month and have no local agency. Other factors that can add complexity to a State agency’s 

program are the challenges of working with large numbers of non-English-speaking participants, 

and the accessibility problems of migrant workers or homeless persons. 

To make sure important factors were adequately addressed, data were examined in aggregate and 

were broken down by— 

 Type of agency—States/DC, ITOs, and U.S. Territories (Puerto Rico, American Samoa, 

Guam, the Commonwealth Islands of the Northern Marianas, and the Virgin Islands). 

 Size of the State agency (measured by participants served per month)—Dividing agencies 

into three approximately equal-size groups based on natural breaks in the data, yielded 

small agencies (with less than 10,000 participants per month); medium-size agencies 

(10,000–74,999); and large agencies (75,000 and above). 

The average State WIC agency oversees 109,395 participants per month, 26 local agencies, 

and 91 clinics or other sites. The number of local agencies overseen ranges from 0 to 118 per 

State WIC agency, with the most agencies being in New York and Texas, while the number of 

clinics under their purview ranges from 0 to 625. Twenty-five State WIC agencies reported 

having zero or one local agency; of these, only Delaware fell into the States/DC agency category. 

Meanwhile 14 State WIC agencies reported having zero or one local clinic. It is noted that the 
Volume 2: State and Local Agencies (Final Report)

 11 National Survey of WIC Participants II 

distinction between State agency, local agency, and clinic is not always clear, especially among 

small ITOs where the State WIC agency may also serve as the local agency and/or the local 

agency may also serve as the clinic. Hence, some ITOs reported this combined State/local as one 

local agency or clinic; others as none. 

 ITOs have the lowest average number of local agencies (2), followed by U.S. Territories 

(20), and States/DC (40). 

 However, with respect to the number of clinics and other sites, U.S. Territories have the 

lowest number (4), followed by ITOs (7), and States/DC (145). 

 Generally, there are more clinics than local agencies. This is not true, however, for U.S. 

Territories. The main reason is that Puerto Rico has 93 local agencies and no clinics, thus 

changing the usual balance. 

 As expected, the larger the State agency, the more local agencies and clinics it has 

on average. 

The median number of local agencies and clinics is consistently lower than the average number, 

sometimes substantially lower, as seen in Exhibit 3-1. 

Exhibit 3-1: Number of Local Agencies and Clinics Under State WIC Agency 

Sites under the State agency 

Type of organization Number of participants 

Total

(n=82)

% 

ITO 

(n=27) 

% 

U.S. 

Territory

(n=5) 

% 

States/DC

(n=50) 

% 

Up to 

10,000 

(n=29) 

% 

10,000 to 

74,999 

(n=21) 

% 

75,000+ 

(n=32) 

% 

WIC local agencies 

Average number 2 20 40 1 16 55 26 

Median number 1 1 24 1 12 49 12 

Range 0—12 0–93 0–118 0–7 0–63 10–118 0–118 

WIC clinics or sites 

Average number 7 4 145 5 55 192 91 

Median number 5 3 113 3 54 153 53 

Range 0–54 0–7 0–625 0–18 1–105 0–625 0–625 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

More than half of the State WIC agencies have participants who are migrant farm workers or 

homeless participants (54.9% and 52.4%, respectively). Within those State WIC agencies, the 

average number of migrant workers is 1,646 participants, and the average number of homeless 

persons is 502 participants (Exhibit 3-2). 

ITOs are the least likely to have migrant farm workers or homeless participants, followed by 

U.S. Territories, and States/DC agencies. With respect to size, smaller agencies are less likely to 

have migrant farm workers or homeless participants. However, medium-size agencies are more 

likely to have homeless participants than are large-size agencies (85.7% and 68.8%, respectively). 
Volume 2: State and Local Agencies (Final Report)

 12 National Survey of WIC Participants II 

Exhibit 3-2: Incidence of Migrant Workers and Homeless Participants 

WIC participants who are... 

Type of organization Number of participants 

Total

ITO 

U.S. 

Territory

States/

DC 

Up to 

10,000 

10,000 to 

74,999 

75,000+

Migrant farm workers: percentage of 

State WIC agencies with >0% 

7.4% 

(n=27) 

20.0% 

(n=5) 

84.0% 

(n=50) 

3.4% 

(n=29) 

81.0% 

(n=21) 

84.4% 

(n=32) 

54.9% 

(n=82) 

Average number of migrant workers 

among State WIC agencies that 

have >0% 

3 

(n=2) 

12 

(n=1) 

1764 

(n=42) 

4 

(n=1) 

38 

(n=17) 

2720 

(n=27) 

1646 

(n=45) 

Homeless: percentage of State WIC 

agencies with >0% 

14.8% 

(n=27) 

40.0% 

(n=5) 

74.0% 

(n=50) 

10.3% 

(n=29) 

85.7% 

(n=21) 

68.8% 

(n=32) 

52.4% 

(n=82) 

Average number of homeless among 

State WIC agencies that have >0% 

16 

(n=4) 

91 

(n=2) 

576 

(n=37) 

8 

(n=3) 

113 

(n=18) 

887 

(n=22) 

502 

(n=43) 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

3.2 Food Packages and Nutritional Services 

Breastfeeding Services 

In continuing efforts to encourage and maintain healthy mothers and their children, the WIC 

Program promotes a wide range of breastfeeding services and support activities to expectant and 

new mothers. When State WIC agencies were asked what, if any, assistance they provided to 

local agencies in relation to breastfeeding, nearly every State agency reported allocating funding 

for breastfeeding coordinators/peer counselors (90.2%) and training for personnel to support 

breastfeeding (93.9%). This is consistent with WIC’s goals to promote breastfeeding, 

requirements that all State WIC agencies have a breastfeeding coordinator, and provide 

breastfeeding training and other materials to their local agencies to educate pregnant women and 

new mothers about having and maintaining healthy children. 

Expectant and new mothers have the opportunity to participate in breastfeeding classes and/or 

support groups and receive educational materials highlighting the nutritional, emotional, and 

financial benefits of breastfeeding to them and their infants. In addition to nutrition education 

and breastfeeding promotion and support (discussed in Section 4.6), nearly all State WIC 

agencies (93.9%) provide printed breastfeeding materials, such as handouts and posters, to their 

participants. Also, 93.9 percent of agencies distribute free breast pumps to new breastfeeding 

mothers in their areas participating in the programs. 

These efforts seem to have helped promote a steady increase in the number of breastfeeding 

mothers since 1988. The number of WIC breastfeeding women in 2009 accounted for 26.8 

percent of all WIC women, compared to 12.7 percent of WIC women in 1988.24 The number of 

breastfeeding mothers has increased 526 percent since 1988 compared to just 196 percent for 

women overall (Exhibit 3-3). 

 

24 U.S. Department of Agriculture, Food and Nutrition Service. (2010). National Survey of WIC Participants II: Participant 

Characteristics Study, p. 22. 
Volume 2: State and Local Agencies (Final Report)

 13 National Survey of WIC Participants II 

Exhibit 3-3: Upward Trend of WIC Breastfeeding Women25

12.7

20.8

26.8

0%

5%

10%

15%

20%

25%

30%

35%

40%

Percentage of

WIC Breastfeeding Mothers

WIC Breastfeeding Mothers

1988                                  1999                                 2009   

Source: National Survey of WIC Participants II: Participant Characteristics Report 

Food Instrument Distribution 

The WIC Program provides nutritious foods to WIC participants through the distribution of food 

vouchers26, which are then exchanged at local grocers for healthy foods—such as formula, milk, 

whole grain bread, eggs, fruits, and vegetables—offered in amounts consistent with the 

recommended nutrient intake of the individual. 

Virtually all States/DC, ITOs, and U.S. Territories (98.9%) distribute food vouchers to WIC 

participants onsite, at their local WIC site, most of the time. This allows the WIC participants to 

maintain contact with their WIC clinic and stay up-to-date on the nutrition education seminars 

and reading materials offered. However, there are exceptions to this rule: WIC clinics will 

usually mail food vouchers to WIC participants who are physically/medically unable to travel to 

their local WIC clinic and who do not have a proxy. 

Recently, Texas and Michigan have moved away from distributing food vouchers onsite and are 

now using electronic benefit transfer (EBT) cards. 

 

25 U.S. Department of Agriculture, Food and Nutrition Service. (2001). National Survey of WIC Participants and their Local Agencies 

(NSWP-I). Retrieved from http://www.fns.usda.gov/oane/MENU/Published/WIC/FILES/WICSurvey.pdf 26 Federal WIC regulations generally use the term “food instrument” instead of “food voucher.” 
Volume 2: State and Local Agencies (Final Report)

 14 National Survey of WIC Participants II 

WIC Nutrition Risk Criteria 

The ultimate goal of the WIC Program is to improve the overall health of nutritionally at-risk 

participants. As such, WIC identifies nutrition risks affecting participants at the time of 

certification and at follow-up recertifications, and classifies them according to their nutrition risk. 

Examples include high maternal weight gain and low hematocrit (anemia). 

In recording these risk criteria, the WIC Program is able to provide appropriate nutrition 

education and referrals for participants, as well as keep track of the prevalence of these risk 

factors over time. The WIC Program expects positive health outcomes and a decrease in the 

prevalence of nutrition risks because of the nutrition services the program provides. 

State WIC agencies were asked to rank the most prevalent nutritional risk criteria for their State, 

by participant category. Looking at the top prevalence criteria, several patterns become apparent 

(Exhibit 3-4): 

 Being overweight is by far the biggest problem for pregnant, breastfeeding, and 

postpartum WIC women. It not only is the number one risk criterion, it is listed among 

the top three criteria by over two-thirds of State WIC agencies. 

 Low hematocrit (anemia) is a major risk, especially for postpartum and breastfeeding 

mothers—listed among the top three criteria by 41.5 percent and 28.0 percent, 

respectively. 

 Inappropriate nutrition practices are also a substantial risk, especially for pregnant and 

postpartum mothers—listed among the top three risk criteria by 30.5 percent and 

25.7 percent, respectively. 

 Finally, closely spaced pregnancies are a fairly common risk among pregnant women, 

with 29.3 percent of agencies designating this as one of the top three risk criteria for 

this group. 

Other risk criteria that stand out are High maternal weight gain (cited as a top three by 36.6% of 

agencies for breastfeeding mothers, and 34.2% for postpartum27 women); Mother of infant at 

nutritional risk (cited as a top three for breastfeeding women by 40.2% of agencies28); and 

Failure to meet the Dietary Guidelines for Americans (cited as a top three by 17.1%, 12.3%, and 

17.1% of agencies for pregnant, breastfeeding, and postpartum women, respectively). 

 

27 It is one of the top three risk criteria for pregnant women in only 4.9 percent of agencies. 28 It is not a top three risk criteria for pregnant women and shows up in only 1.2 percent of agencies for postpartum women. 
Volume 2: State and Local Agencies (Final Report)

 15 National Survey of WIC Participants II 

Exhibit 3-4: Most Prevalent Risk Criteria 

in Pregnant, Breastfeeding, and Postpartum Women 

Category/ 

Prevalence Level 

Overweight 

women 

% 

Low 

hematocrit 

% 

Closely spaced 

pregnancies 

% 

Inappropriate 

nutrition practices 

for women 

% 

Pregnant 

Most prevalent 50.0 1.2 1.2 13.4

2nd Most prevalent 13.4 6.1 12.2 9.8

3rd Most prevalent 6.1 4.9 15.9 7.3

Total (1st, 2nd, 3rd) 69.5 12.2 29.3 30.5

Breastfeeding 

Most prevalent 28.0 1.2 1.2 6.1

2nd Most prevalent 28.0 6.1 6.1 6.1

3rd Most prevalent 12.2 20.7 3.7 6.1

Total (1st, 2nd, 3rd) 68.2 28.0 11.0 18.3

Postpartum 

Most prevalent 45.1 3.7 0.0 11.0

2nd Most prevalent 15.9 17.1 6.1 9.8

3rd Most prevalent 6.1 20.7 12.2 4.9

Total (1st, 2nd, 3rd) 67.1 41.5 18.3 25.7

n=82 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

For infants, the most prevalent risk criterion is Inappropriate nutrition practices, which is listed 

as one of the top-three most prevalent risks by 43.9 percent of State WIC agencies. As seen in 

Exhibit 3-5, the next most common risk criteria are Prematurity (15.8% as top three); 

Underweight or at-risk (13.4%); and Short stature or Low birth weight (both at 11.0%). 

Exhibit 3-5: Common Prevalent Risk Criteria in Infants in the WIC Program 

Underweight 

or at-risk 

% 

Short stature 

or at-risk 

% 

Low birth 

weight 

% 

Prematurity

% 

Inappropriate nutrition 

practices for infants 

% 

Most prevalent 1.2 1.2 0 0 7.3 

2nd Most prevalent 3.7 4.9 3.7 7.3 15.9 

3rd Most prevalent 8.5 4.9 7.3 8.5 20.7 

Total (1st, 2nd, 3rd) 13.4 11.0 11.0 15.8 43.9 

n=82 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

Similar to infants, the most prevalent risk criterion is inappropriate nutrition practices for 

children, which is cited by 87.9 percent of State WIC agencies as a top three risk. Far behind that, 

but still substantial are being At risk of becoming overweight, Overweight, and Low hematocrit, 

which are listed among the top three most prevalent criteria for 35.4 percent, 20.8 percent, and 

19.5 percent, respectively (Exhibit 3-6 and/or Appendix C). 
Volume 2: State and Local Agencies (Final Report)

 16 National Survey of WIC Participants II 

Exhibit 3-6: Common Prevalent Risk Criteria in Children in the WIC Program 

Overweight 

children 

(age 2–5 years) 

% 

At risk of becoming 

overweight 

% 

Low hematocrit 

% 

Inappropriate 

nutrition practices 

for children 

% 

Most prevalent 3.7 6.1 2.4 47.6 

2nd Most prevalent 7.3 12.2 9.8 23.2 

3rd Most prevalent 9.8 17.1 7.3 17.1 

Total (1st, 2nd, 3rd) 20.8 35.4 19.5 87.9 

n=82 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

3.3 Certification Process 

To be eligible for WIC benefits, applicants must show income at or below a level of the 

standards set by the State agency, or be determined adjunctively income-eligible based on their 

participation in certain means-tested programs. 

Income Eligibility—Applicant household gross income falls at or below 185 percent of the 

Federal Poverty Level (FPL) income guidelines. (In 2009, 185 percent FPL was equal to 

$39,220 for a family of four in the 48 Contiguous States, D.C., and the U.S. Territories.) 

Adjunctive Income Eligibility—Applicant (or family member) meets the income 

requirements through participation in Medicaid, SNAP, or TANF. 

Automatic Income Eligibility—Applicant meets the income requirements through 

participation in a State means-tested program, as specified by the State agency. 

The process of determining eligibility is through certification and is the primary administrative 

function of the State. Federal WIC Program regulations grant State WIC agencies a certain 

amount of discretion in determining eligibility in several areas: 

 Income Eligibility: 

 Income level (e.g., 185% of the FPL or State/local guidelines within defined limits); 

 Definition of income (per WIC guidance or other within defined limits; further State 

WIC agencies may use the past 12 months or “current” income with the latter 

not defined); 

 Proof of income (WIC guidelines for no documentation or proof or other); 

 Family economic unit (per Federal definition or State household guidelines), including 

children in temporary care or friends/relatives (full discretion); 

 Automatic income eligibility, with some discretion on the use of acceptable 

State programs; 
Volume 2: State and Local Agencies (Final Report)

 17 National Survey of WIC Participants II 

 Certification period (selected areas of full State discretion); and 

 Proof of residency and identity (full State discretion). 

The regulations further grant State WIC agencies the discretion to defer eligibility determination 

to local agencies in selected areas of consideration. However, with the implementation of 

statewide data systems for determining certification, this local discretion is diminishing. 

Income Eligibility 

If WIC applicants are not adjunctively or automatically income eligible for benefits, they must 

qualify based on their household income levels to receive benefits, as is the case for 

approximately 30 percent of those eligible nationwide. These qualifying income levels are based 

on 185 percent of the FPL: the larger the household, the higher the allowable income for 

qualification. 

The methods by which the State WIC agencies compute household income and how income 

sources are verified are central to the determination of income eligibility. Questions related to the 

computation of income are affected by the eligibility decisions made at the State or local agency 

level, the eligibility criteria—including sources of income that are included or excluded—and the 

guidelines that are used. 

State agencies were asked if they grant discretion to local agencies regarding income eligibility 

determination; just over half (53.7%) said that they do. Unfortunately, a follow-up question 

designed to gain further understanding regarding the nature of this discretion yielded inconsistent 

responses, so it is unclear if the question on discretion was consistently interpreted. This suggests 

caution should be used regarding the responses to this question. 

The types of income that count in the determination of total household income are shown in 

Exhibit 3-7. For many income types—for example, wages/salary/fees, self-employment income, 

unemployment compensation, child support, Social Security, alimony, regular contributions from 

persons not in household, workers compensation, and other cash income—there is a high degree 

of consensus among State WIC agencies that these should be counted. For other sources of 

income—for example, medical assistance, rental assistance and energy assistance—there is less 

uniformity, with some State WIC agencies counting the source, while others do not. 

Beyond the sources mentioned above, there are striking differences in what is considered income 

between ITOs, U.S. Territories, and States/DC as well as between agencies by size. Although the 

degree depends on the specific source in question, ITOs and U.S. Territories are much less likely 

to consider certain sources as income than their States/DC counterparts. Similarly, the smaller 

agencies (a group that overlaps with ITOs and U.S. Territories) are similarly less inclined to 

count a source as income. 
Volume 2: State and Local Agencies (Final Report)

 18 National Survey of WIC Participants II 

Exhibit 3-7: Sources Counted in Determining Income 

Types of income counted 

Type of organization Number of participants 

Total

(n=82)

% 

ITO 

(n=27) 

% 

Territory

(n=5) 

% 

States/DC

(n=50) 

% 

Up to 

10,000 

(n=29) 

% 

10,000 to 

75,000 

(n=21) 

% 

More than 

75,000 

(n=32) 

% 

Wages, salary, fees 100.0 100.0 100.0 100.0 100.0 100.0 100.0 

Self-employment 92.6 100.0 100.0 93.1 100.0 100.0 97.6 

Unemployment compensation 92.6 40.0 100.0 82.8 100.0 100.0 93.9 

Child support 85.2 80.0 100.0 82.8 100.0 100.0 93.9 

Social Security 85.2 100.0 98.0 86.2 95.2 100.0 93.9 

Alimony 55.6 80.0 98.0 55.2 95.2 100.0 82.9 

Regular contributions from 

persons not in household 51.9 80.0 100.0 55.2 95.2 100.0 82.9 

Workers compensation 74.1 40.0 90.0 65.5 90.5 90.6 81.7 

Other cash income 59.3 80.0 92.0 58.6 90.5 93.8 80.5 

Public assistance 63.0 80.0 88.0 62.1 90.5 87.5 79.3 

Private pension 48.1 60.0 98.0 48.3 90.5 100.0 79.3 

Supplemental Security Income—

Federal Government 66.7 40.0 90.0 65.5 85.7 87.5 79.3 

Tips and bonuses 51.9 40.0 96.0 48.3 95.2 93.8 78.0 

Disability pension 59.3 40.0 92.0 58.6 90.5 87.5 78.0 

Supplemental Security Income—

State issued 59.3 20.0 90.0 55.2 90.5 84.4 75.6 

Income from estates 44.4 40.0 94.0 44.8 90.5 90.6 74.4 

Income from trusts 37.0 60.0 96.0 37.9 95.2 93.8 74.4 

Commissions 44.4 60.0 90.0 44.8 81.0 93.8 73.2 

Welfare 48.1 40.0 88.0 44.8 85.7 87.5 72.0 

Net royalties 40.7 20.0 92.0 37.9 76.2 96.9 70.7 

Dividends or interest from savings 44.4 -- 92.0 37.9 85.7 90.6 70.7 

Net rental income 37.0 60.0 82.0 41.4 71.4 84.4 65.9 

Medical assistance 11.1 20.0 38.0 13.8 52.4 25.0 28.0 

Rental assistance -- 20.0 36.0 3.4 42.9 28.1 23.2 

Energy assistance 3.7 20.0 32.0 6.9 42.9 21.9 22.0 

Other 14.8 -- 26.0 6.9 23.8 31.3 20.7 

Source: National Survey of WIC Participants II: State and Local Agencies Report

Most agencies allow the exclusion of military housing allowances, in the computation of income to 

determine eligibility; three-fourths exclude the Basic Allowance for Housing (BAH) and more than 

half exclude other housing allowances. Overall, ITOs are by far the most likely to include all such 

allowances (thus excluding none) in their income totals (40.7%) compared with U.S. Territories 

(20.0%) and States/DC (8.0%) (Exhibit 3-8). 
Volume 2: State and Local Agencies (Final Report)

 19 National Survey of WIC Participants II 

Exhibit 3-8: Exclusion of Military Housing Allowances 

Type of organization Number of participants 

Total

(n=82)

% 

ITO 

(n=27) 

% 

Territory

(n=5) 

% 

States/DC

(n=50) 

% 

Up to 

10,000 

(n=29) 

% 

10,000 to 

74,999 

(n=21) 

% 

75,000+ 

(n=32) 

% 

Basic Allowance for Housing for 

off-base housing and privatization 

housing in the U.S. 

51.9 80.0 90.0 55.2 81.0 93.8 76.8 

Family Separation Housing (FSH) 

provided to military personnel for 

overseas housing 

37.0 40.0 62.0 37.9 57.1 62.5 52.4 

Overseas Housing Allowance 

(OHA) provided to military 

personnel living overseas 

37.0 40.0 66.0 37.9 61.9 65.6 54.9 

Overseas Continental U.S. 

(OCONUS) cost of living 

allowance (COLA) provided to 

active duty uniformed service 

members in Hawaii, Alaska, 

and Guam 

44.4 60.0 74.0 48.3 71.4 71.9 63.4 

None 40.7 20.0 8.0 37.9 14.3 6.3 19.5 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

When unemployment is not an issue, most agencies (62.2%) use the current income, as opposed to 

income from the previous year, to determine income-based eligibility (Exhibit 3-9). Few agencies 

(13.4%) leave this determination up to the local agencies. 

Exhibit 3-9: Income Timeframe 

Type of organization Number of participants 

Total

(n=82)

% 

ITO 

(n=27) 

% 

Territory

(n=5) 

% 

States/DC

(n=50) 

% 

Up to 

10,000 

(n=29) 

% 

10,000 to 

74,999 

(n=21) 

% 

75,000+ 

(n=32) 

% 

Income from last year used 3.7 -- 4.0 3.4 -- 6.3 3.7 

Current income used 81.5 100.0 48.0 86.2 47.6 50.0 62.2 

Left to local agencies to decide 7.4 -- 18.0 3.4 23.8 15.6 13.4 

Other 7.4 -- 30.0 6.9 28.6 28.1 20.7 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

To determine most recent income, about one-third of State WIC agencies (36.6%) use the latest 

pay stub/earnings statement (36.6%) and another one-third use the most recent 30 days or 

calendar month (32.9%). The remaining agencies use income from the previous 60 days (7.3%), 

previous 90 days (4.9%), previous 12 months (7.3%), or said the question was not applicable 

(11.0%). 
Volume 2: State and Local Agencies (Final Report)

 20 National Survey of WIC Participants II 

State and Local Agencies 

Evidence of income—that is, the types of proof that State WIC agencies will accept to 

demonstrate income—varies somewhat by State agency; however, variation is less than in other 

areas of State agency discretion, such as sources of income or time period for calculating income. 

The types of acceptable proofs of income are shown in Exhibit 3-10 in decreasing order of 

acceptance. Acceptable proofs that are cited by more than 90 percent of the State WIC agencies 

are pay stubs, signed statements by employers, and most recent tax returns. In addition, 

statements of child support or alimony, court or public agency statements of benefits, and 

officially signed unemployment letters or attestations of low income (all above 85%) are cited 

frequently. 

The number of income proofs considered acceptable tends to increase with the size of the agency; 

i.e., the larger agencies accept more forms of income proof.29 For applicants who are unlikely to 

have any proof of income, virtually all State WIC agencies (97.6%) allow self-declaration of 

income in the form of a statement signed by the applicant attesting to the reason for the absence 

of proof. 

Exhibit 3-10: Accepted Proofs of Income 

Type of organization Number of participants 

Total

(n=82)

% 

ITO 

(n=27)

% 

Territory

(n=5) 

% 

States/

DC 

(n=50)

% 

Up to 

10,000

(n=29)

% 

10,000 

to 

74,999 

(n=21) 

% 

75,000

+ 

(n=32)

% 

Check/pay stubs 100.0 100.0 96.0 100.0 95.2 96.9 97.6 

Signed statement by employer 88.9 100.0 96.0 89.7 95.2 96.9 93.9 

Most recent tax return 88.9 80.0 96.0 89.7 95.2 93.8 92.7 

Statement of benefits for child support and alimony 77.8 80.0 94.0 75.9 90.5 96.9 87.8 

Statement of benefits by public agency or court 70.4 80.0 94.0 75.9 85.7 93.8 85.4 

Leave and Earnings Statement (LES) for military pay 70.4 60.0 96.0 72.4 90.5 93.8 85.4 

Unemployment letter or notice letter signed by 

official State/local agency attesting to participant’s 

low income 

81.5 80.0 88.0 82.8 85.7 87.5 85.4 

Savings statement from bank or other financial 

institution (e.g., direct deposit) 59.3 60.0 80.0 65.5 61.9 84.4 72.0 

Written statement from reliable third party 48.1 80.0 82.0 51.7 71.4 87.5 70.7 

Accounting records (for self-employed individuals) 51.9 80.0 78.0 55.2 61.9 87.5 69.5 

Scholarship letter (e.g., for students) 51.9 20.0 66.0 44.8 57.1 71.9 58.5 

Other 7.4 -- 16.0 -- 23.8 15.6 12.2 

None -- -- 2.0 -- 4.8 -- 1.2 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

 

29 This may be a reflection of the inclusion of more types of income by the larger agencies, as shown in Exhibit 3-8. 
Volume 2: State and Local Agencies (Final Report)

 21 National Survey of WIC Participants II 

With regard to the certification period used for applicants who are temporarily low-income, such 

as strikers, most agencies (85.4%) allow the full certification period, as opposed to shortening 

the certification period based on anticipated future income increases, as shown in Exhibit 3-11. 

Fewer of the smaller agencies allow the full certification period than larger agencies. 

Exhibit 3-11: Certification Period for Temporarily Low-Income Applicants 

Type of organization Number of participants 

Total

(n=82)

% 

ITO 

(n=27) 

% 

Territory

(n=5) 

% 

States/DC

(n=50) 

% 

Up to 

10,000 

(n=29) 

% 

10,000 to 

74,999 

(n=21) 

% 

75,000+ 

(n=32) 

% 

Allows full certification period 74.1 80.0 92.0 72.4 90.5 93.8 85.4 

Shortens certification period based 

on anticipated income increase 22.2 20.0 4.0 24.1 4.8 3.1 11.0 

No response/missing 3.7 -- 4.0 3.4 4.8 3.1 3.7 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

Family Economic Unit 

The majority of the State WIC agencies (58.5%) do not give any additional discretion to local 

agencies in determining the WIC economic/family unit, thus relying on the national WIC Program 

definition (Exhibit 3-12). When State WIC agencies give discretion to local agencies, it is usually 

in policy directives that often shed additional light on FNS’ policy definition. For example, one 

State explains, “The terms ‘economic unit’ or ‘household size’ can be used interchangeably. 

However, ‘economic unit’ is a more appropriate term to use because it conveys that familial 

relationship is not relevant to the determination of family size and income.” More than half of State 

agencies (56.0%) grant discretion compared with only one-fifth of ITOs (18.5%) and U.S. 

Territories (20.0%). Large- and medium-size State WIC agencies are at least three times more 

likely to grant discretion (50.0% and 61.9%, respectively) than small State WIC agencies (17.2%). 

Exhibit 3-12: Additional Guidelines, if any, Given by State to Local WIC Agency to 

Determine Economic/Family Unit 

Type of organization Number of participants 

Total

(n=82)

% 

ITO 

(n=27) 

% 

Territory

(n=5) 

% 

States/DC

(n=50) 

% 

Up to 

10,000 

(n=29) 

% 

10,000 to 

74,999 

(n=21) 

% 

75,000+ 

(n=32) 

% 

No additional discretion is given 81.5 80.0 44.0 82.8 38.1 50.0 58.5 

Discretion is given 18.5 20.0 56.0 17.2 61.9 50.0 41.5 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

Another concern in the family economic unit is the status of children in the temporary care of 

friends or relatives. Approximately 40 percent of State WIC agencies either count them as part of 

the economic unit of the person with whom they are currently residing (41.5%) or as a separate 

unit (37.8%) (Exhibit 3-13). Only a very small minority of State WIC agencies (8.5%) count 

absent parents and children in temporary care of friends or relatives as one family unit. ITOs and 
Volume 2: State and Local Agencies (Final Report)

 22 National Survey of WIC Participants II 

the smaller agencies most often count the children as a separate unit (70.4% and 65.5%, 

respectively). 

Exhibit 3-13: Status of Children in Temporary Care of Friends or Relative 

in Terms of Family Economic Unit 

Type of organization Number of participants 

Total

(n=82)

% 

ITO 

(n=27) 

% 

Territory

(n=5) 

% 

States/DC

(n=50) 

% 

Up to 

10,000 

(n=29) 

% 

10,000 to 

74,999 

(n=21) 

% 

75,000+ 

(n=32) 

% 

Count the children as a separate 

unit in which case they should 

have separate income 

70.4 40.0 20.0 65.5 14.3 28.1 37.8 

Count the children as part of the 

economic unit of the person with 

whom they are residing 

11.1 60.0 56.0 17.2 57.1 53.1 41.5 

Count absent parents and children 

together as one unit 11.1 -- 8.0 10.3 9.5 6.3 8.5 

None of the above 7.4 -- 16.0 6.9 19.0 12.5 12.2 

Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

Adjunctive Eligibility 

The majority of WIC participants meet the income requirement through proven participation in 

certain other means-tested programs referred to as adjunctive eligibility. State WIC agencies are 

required by law to base adjunctive income eligibility on SNAP, Medicaid, and TANF, as 

reflected in the frequency of acceptance of these programs by State WIC agencies, which is 

100%, 100%, and 98.8%,30 respectively. 

The programs selected by State WIC agencies to use as the bases for automatic income eligibility, 

and the percentage of State WIC agencies that accept the automatic eligibility, include— 

 State Children’s Health Insurance (SCHIP)—46.3%; 

 Food Distribution Program on Indian Reservations (FDPIR)—28%; 

 Supplemental Security Income (SSI)—20.7%; 

 The National School Lunch/School Breakfast Programs (NSLP and NSBP)—14.6%; and 

 The Low-Income Home Energy Assistance Program (LIHEAP)—6.1%. 

Applicants must demonstrate their participation in these programs by presenting an award letter, 

an active program voucher, or other accepted proof of participation at the time of their 

application, such as a program card. The most common proof provided is in the form of a 

program award letter or proof of certification, such as a program card (Exhibit 3-14). 

An example of a program card is the SNAP EBT card. 

 

30 Northern Marianas noted that TANF is not applicable in their State agency. 
Volume 2: State and Local Agencies (Final Report)

 23 National Survey of WIC Participants II 

Exhibit 3-14: Percentage of Top Three Adjunctive Eligibility Proofs Accepted, by Program SNAP Medicaid TANF Children’s Medicaid SSI Free and Reduced School Meal Program FDPIR LIHEAP 

Proof of certification (i.e., card) 40.2 56.1 39.0 29.3 8.5 3.7 13.4 2.4 

Program award letter 63.4 50 56.1 28 14.6 8.5 9.8 1.2 

Active program voucher 4.9 4.9 6.1 3.7 2.4 1.2 1.2 1.2 

n=82 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

Certification Period 

The two areas of consideration within the broader topic of a certification period are the transition 

from infant to child, and the type of month (data or calendar) used. For both of these areas, State 

WIC agencies are given several options in the guidelines. 

When an infant turns 1 year old, most agencies (56.1%) consider the infant categorically 

ineligible and require recertification based on criteria for a child (Exhibit 3-15). Slightly more 

than one-third of the agencies (34.1%) reported that the 6-month certification period remains 

valid for the infants who turn 1 year of age. ITOs and the smaller agencies are the least likely to 

keep the 6-month certification valid (22.2% and 17.2%, respectively) and the most likely to 

consider 1 year old infants categorically ineligible and thus require recertification (74.1% and 

75.9%, respectively). One in 10 State WIC agencies has no set policy and gives discretion to the 

local agency. 

Exhibit 3-15: Categorical Eligibility of Infants After Turning 1 Year Old 

Type of organization Number of participants 

Total

(n=82)

% 

ITO 

(n=27)

% 

Territory

(n=5) 

% 

States/DC

(n=50) 

% 

Up to 

10,000

(n=29)

% 

10,000 to 

74,999 

(n=21) 

% 

75,000+

(n=32) 

% 

The 6-month certification period 

remains valid. 22.2 40.0 40.0 17.2 42.9 43.8 34.1 

The infant becomes categorically 

ineligible and needs to again be certified. 74.1 40.0 48.0 75.9 38.1 50.0 56.1 

Neither: There is no State policy; 

discretion is given to local agencies. 3.7 20.0 12.0 6.9 19.0 6.3 9.8 

Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 

Source: National Survey of WIC Participants II: State and Local Agencies Report 
Volume 2: State and Local Agencies (Final Report)

 24 National Survey of WIC Participants II 

The majority of the State WIC agencies (67.1%) use the data month 31 for issuance cycles 

(Exhibit 3-16), with ITOs and the smaller States/DC being the least likely to use the data month 

(51.9% and 51.7%, respectively). The vast majority of State WIC agencies (85.4%) allow a full 

certification period for temporary low-income persons, and only a small minority (11.0%) shorten 

the certification period based on an anticipated income increase. States/DC and the larger agencies 

are the most likely to allow a full certification period for temporary low-income participants 

(92.0% and 93.8%, respectively). Conversely, ITOs and the smaller agencies are the least likely to 

allow a full certification period (74.1% and 72.4%, respectively). Furthermore, almost threefourths of the agencies (72.0%) do not grant any additional discretion to local agencies regarding 

certification periods, with ITOs and the smaller agencies being the most likely not to allow 

discretion to local agencies on certification periods for temporary low-income families (85.2% and 

86.2%, respectively). 

Exhibit 3-16: Characteristics of Certification Periods 

Type of organization Number of participants 

Total

(n=82)

% 

ITO 

(n=27)

% 

U.S. 

Territory

(n=5) 

% 

States/DC

(n=50) 

% 

Up to 

10,000

(n=29)

% 

10,000 to 

74,999 

(n=21) 

% 

75,000+

(n=32) 

% 

Does your State agency 

use a data month or 

calendar month for 

issuance cycles? 

Calendar month 48.1 40.0 24.0 48.3 14.3 31.3 32.9 

Data month 51.9 60.0 76.0 51.7 85.7 68.8 67.1 

For temporary lowincome persons, does the 

State agency allow the full 

certification period or 

shorten the certification 

period based on an 

anticipated income 

increase? 

Allows full 

certification period 74.1 80.0 92.0 72.4 90.5 93.8 85.4 

Shortens 

certification period 

based on 

anticipated income 

increase 

22.2 20.0 4.0 24.1 4.8 3.1 11.0 

N/A 3.7 -- 4.0 3.4 4.8 3.1 3.7 

What other discretion, if 

any, does the State agency 

use or grant to local 

agencies regarding 

certification periods? 

No additional 

discretion is given 85.2 60.0 66.0 86.2 57.1 68.8 72.0 

Other discretion is 

given 14.8 40.0 34.0 13.8 42.9 31.3 28.0 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

Residential Eligibility 

Proof of residency is an important component in determining an applicant’s eligibility for WIC 

benefits. Not only is proof of residency mandatory for certification, in many cases it also 

determines from which WIC clinic an applicant may receive benefits. Nearly all States/DC, ITOs, 

and U.S. Territories (91.5%) require applicants to present evidence that they live in the 

States/DC, ITO, or U.S. Territory in which they apply at the time of application. The remaining 

8.5 percent that do not require residency are all ITOs. There is no duration of residency length 

 

31 Data month means WIC benefits continue until the next 30-day period of eligibility ends whereas calendar month means 

WIC benefits continue until the end of the month. 
Volume 2: State and Local Agencies (Final Report)

 25 National Survey of WIC Participants II 

requirement for eligibility. Applicants who live in areas where the WIC Program is administered 

by an ITO must meet the residency requirements established by the ITO. 

Some State WIC agencies require applicants to apply to the WIC clinic that serves the local area 

where they live. For instance, in large cities, such as Los Angeles, California, more than one 

WIC clinic may serve the area. However, depending on residency, applicants are only allowed to 

apply for benefits from the WIC clinic assigned to their district or region. These boundaries 

between WIC local agencies and/or clinics are not always clear-cut and may overlap. Although 

some local agencies have clear-cut boundaries or jurisdictions (39.0%), frequently there is 

overlap between local agencies (61.0%). 

More specifically, nearly three-fifths (57.3%) of the States/DC, ITOs, and U.S. Territories 

simply require applicants to show proof of residency somewhere within the State/DC, ITO, or 

U.S. Territory. As seen in Exhibit 3-17, the remaining entities have either designated boundary 

areas by the local WIC clinic (11.0%) or local agency (12.2%), or the boundary decision is left to 

the discretion of the local agency and or clinics (13.4%). A small percentage of State WIC 

agencies (6.1%)—most of them ITOs—specified that applicants are required to live within 

Indian reservation boundaries. 

Exhibit 3-17: Residency Requirements 

Type of organization 

Total 

(n=82) 

% 

ITO 

(n=27) 

% 

U.S. 

Territory 

(n=5) 

% 

States/DC 

(n=50) 

% 

WIC participants must reside within the boundary of the WIC 

local clinic where she/he resides. 25.9 20.0 2.0 11.0 

WIC participants must reside within the boundary of the WIC 

local agency (overseeing the clinic) where she/he resides. 7.4 20.0 14.0 12.2 

WIC participants only need to show that they live somewhere 

within the State. 40.7 60.0 66.0 57.3 

The decision is left to local agencies and/or clinics. 14.8 -- 14.0 13.4

Other 11.1 -- 4.0 6.1

Total 100.0 100.0 100.0 100.0

Source: National Survey of WIC Participants II: State and Local Agencies Report 

To determine residency eligibility, applicants must present proof of residence at the time of 

application. State WIC agencies were asked to report the types of identification they accept to 

verify residency. Exhibit 3-18 shows that State WIC agencies rely heavily on documents such as 

utilities or tax bills (92.7%), as well as receipts for rent, lease, and mortgage payments (86.6%), 

as proof of residency. These proofs must have a current physical address on them, as well as the 

name of the applicant. State agencies also accept—in large part—written statements from 

reliable third parties (61.0%) and signed statements by applicants explaining that they are victims 

of a loss or disaster, homeless, migrants, or military personnel (72.0%). Alternate types of 

residency proofs are an applicant’s voter registration card/letter, or any government, official, or 

business mail addressed to the applicant and postmarked by the U.S. Postal Service. 
Volume 2: State and Local Agencies (Final Report)

 26 National Survey of WIC Participants II 

Exhibit 3-18: Types of Identification That Are Acceptable 

to Verify Residency of a WIC applicant 

Type of Documentation 

Total 

(n=82) 

% 

Current utility or tax bill with address on it 92.7

Rent receipt, mortgage receipt, or lease 86.6

Signed statement attesting that applicants are victims of loss or disaster, are homeless, migrants, or 

military personnel 72.0 

Driver’s license 72.0

Written statement from reliable third party 61.0

Other (voter registration, government mail with address and postmark, etc.) 56.1

Checkbook 19.5

Source: National Survey of WIC Participants II: State and Local Agencies Report 

Given the potential for overlap between different local agencies and/or clinics, it is important 

that there are protocols to prevent duplicate WIC participant certifications between local 

agencies. To ascertain this, agencies were asked how often they regularly review the records of 

WIC participants to identify duplicate certifications. Exhibit 3-19 shows that two-thirds (65.9%) 

of the State WIC agencies reported that the process is automated and that the system constantly 

looks for duplicate records at every request for certification/recertification. The larger the State 

WIC agency, the more likely it is to use an automated, constant review process, i.e., more than 

three-fourths of large State WIC agencies (78.1%) and nearly as many medium-size State WIC 

agencies (71.4%), compared with only about half of the smaller agencies (48.3%). The smaller 

agencies tend to be ITOs where the automated, constant review process is also low (40.7%). 

Other State WIC agencies reported looking for duplicate records on a monthly (7.3%), quarterly 

(13.4%), or semiannually (6.1%) basis. A few agencies reported only annual audits (3.7%) and, 

in some cases, they responded that they did not know the frequency (3.7%) (Exhibit 3-19). 

Exhibit 3-19: Review of the Records of WIC Participants 

to Identify Duplicate Certifications Across Local Agencies 

Frequency of State review 

to identify duplicate 

certifications across agencies 

Type of organization Number of participants 

Total 

(n=82)

% 

ITO 

(n=27) 

% 

U.S. 

Territory

(n=5) 

% 

States/ 

DC 

(n=50) 

% 

Up to 

10,000 

(n=29) 

% 

10,000 to 

74,999 

(n=21) 

% 

75,000+

(n=32) 

% 

Process is automated and constant 40.7 100.0 76.0 48.3 71.4 78.1 65.9 

10–12 times a year (e.g., monthly) 3.7 -- 10.0 3.4 9.5 9.4 7.3 

7–9 times a year -- -- -- -- -- -- -- 

4–6 times a year (e.g., quarterly) 29.6 -- 6.0 27.6 9.5 3.1 13.4 

2–3 times a year (e.g., semiannually) 11.1 -- 4.0 10.3 4.8 3.1 6.1 

Once a year or less often 7.4 -- 2.0 6.9 -- 3.1 3.7 

Never -- -- -- -- -- -- -- 

Don’t know 7.4 -- 2.0 3.4 4.8 3.1 3.7 

Source: National Survey of WIC Participants II: State and Local Agencies Report 
Volume 2: State and Local Agencies (Final Report)

 27 National Survey of WIC Participants II 

Denials 

The overwhelming majority of the State WIC agencies (87.8%) have a policy that requires local 

WIC agencies to keep information on denied applicants (Exhibit 3-20). The type or the size of 

the agency had no clear relationship to this policy. With respect to the types of information on 

denied applicants that are required to be retained by the State, the majority of the State agencies 

all keep different types of information. The most frequently kept information on denied 

applicants are name of applicant (85.4%), reason for denial (85.4%), and date of denial (81.7%). 

Data on denied applicants that were kept slightly less frequently include date of application 

(72%), address (65.9%), WIC applicant category (65.9%), and telephone number (62.2%). 

The type of the agency has no clear relationship to the various types of information kept on 

denied applicants. 

With respect to how the information on denied applicants is stored, more than one-third of the 

agencies (35.4%) use both paper and electronic copies, and more than one-fourth use either paper 

(26.8%) or electronic copies (25.6%). 

The vast majority of the State agencies (87.8%) also reported that it is State policy to have local 

agencies send an official letter of denial to applicants who are denied eligibility for WIC. 

U.S. Territories are less likely to have this State policy of sending an official letter of denial to 

applicants (60.0%).32

Exhibit 3-20: Required Documentation on Denied Applicants 

State policy requirements 

of local agencies 

Type of organization Number of participants 

Total 

(n=82)

% 

ITO 

(n=27) 

% 

Territory

(n=5) 

% 

States/

DC 

(n=50)

% 

Up to 

10,000 

(n=29) 

% 

10,000 to 

74,999 

(n=21) 

% 

75,000+ 

(n=32) 

% 

Agencies must keep 

information on denied 

applicants 

85.2 100.0 88.0 89.7 90.5 84.4 87.8 

Specific items on denied applicants that must be retained 

Name of applicant 81.5 100.0 86.0 86.2 90.5 81.3 85.4 

Reason for denial 81.5 100.0 86.0 86.2 90.5 81.3 85.4 

Date of denial 77.8 100.0 82.0 82.8 90.5 75.0 81.7 

Date of application 77.8 80.0 68.0 82.8 81.0 56.3 72.0 

Address 77.8 20.0 64.0 72.4 81.0 50.0 65.9 

WIC applicant category 70.4 80.0 62.0 75.9 76.2 50.0 65.9 

Telephone number 70.4 20.0 62.0 65.5 81.0 46.9 62.2 

 

32 Anecdotally, in our attempt to gain the cooperation of States in keeping information on denied applicants for our survey of 

denied applicants, we learned that some prospective applicants inquired about the eligibility criteria and decided not to file an 

application on the assumption that they will be denied. 
Volume 2: State and Local Agencies (Final Report)

 28 National Survey of WIC Participants II 

State policy requirements 

of local agencies 

Type of organization Number of participants 

Total 

(n=82)

% 

ITO 

(n=27) 

% 

Territory

(n=5) 

% 

States/

DC 

(n=50)

% 

Up to 

10,000 

(n=29) 

% 

10,000 to 

74,999 

(n=21) 

% 

75,000+ 

(n=32) 

% 

How denied applicant information is retained 

No specific retention 

requirements 14.8 -- 12.0 10.3 9.5 15.6 12.2 

Paper copy only 18.5 40.0 30.0 24.1 33.3 25.0 26.8 

Electronic copy only 33.3 20.0 22.0 31.0 19.0 25.0 25.6 

Both paper and electronic 33.3 40.0 36.0 34.5 38.1 34.4 35.4 

Local agencies must send an 

official letter to applicants who 

are denied eligibility for WIC. 

88.9 60.0 90.0 89.7 90.5 84.4 87.8 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

Proxies 

The most frequently reported actions that designated proxies are allowed to perform on behalf of 

the WIC participants they represent include picking up food instruments (95.1%), spending food 

instruments (92.7%), and attending educational sessions (81.7%) (Exhibit 3-21). However, 

nearly half of the agencies (46.3%) allow proxies to obtain certification for the WIC applicant. 

Differences by type and size of agency are relatively modest, although the large agencies are 

more likely to allow proxies to attend educational sessions (90.6%) than small (75.9%) and 

medium-size (76.2%) agencies. 

Exhibit 3-21: Actions That Designated Proxies Are Allowed To Do 

in a State on Behalf of the WIC Participants They Represent 

Actions permitted 

Type of organization Number of participants 

Total

(n=82)

% 

ITO 

(n=27) 

% 

Territory

(n=5) 

% 

States/DC

(n=50) 

% 

Up to 

10,000 

(n=29) 

% 

10,000 to 

74,999 

(n=21) 

% 

75,000+ 

(n=32) 

% 

Pick up food instruments 92.6 100.0 96.0 93.1 95.2 96.9 95.1 

Spend food instruments 92.6 100.0 92.0 93.1 85.7 96.9 92.7 

Attend educational sessions 70.4 100.0 86.0 75.9 76.2 90.6 81.7 

Get certification for the WIC 

applicant 55.6 40.0 42.0 55.2 42.9 40.6 46.3 

Other -- -- 10.0 -- 9.5 9.4 6.1 

Not applicable—State does not 

allow proxies 3.7 -- 2.0 3.4 -- 3.1 2.4 

Source: National Survey of WIC Participants II: State and Local Agencies Report 
Volume 2: State and Local Agencies (Final Report)

 29 National Survey of WIC Participants II 

3.4 Recordkeeping and Systems 

State WIC agencies were asked questions about their recordkeeping practices and information 

systems. These questions addressed the various types of information retained, as well as the 

means and duration of information storage. Participant data are gathered at the time of 

certification and recertification, and are used to approve or deny WIC benefits. The information 

is used primarily to identify participants, assign the appropriate food package, and identify the 

nutrition education and other services that may be needed. 

Recordkeeping at the State Agency Level 

The method of recordkeeping and information systems differs from one State WIC agency to the 

next, often depending on the number of WIC participants served and the technical capabilities of 

administrative offices. An overwhelming majority (85.4%) of State WIC agencies keep current 

and previous information about participant names for over a year, with the rest retaining only the 

most current participant names. Participant data items that State WIC agencies are most likely to 

keep longer than a year are participant’s category of eligibility, food packages issued, clinic 

attended, family identify numbers, value of food packages redeemed, program by which the 

participant was adjunctively qualified, and the participant’s address—each of which is retained 

for over 1 year by more than 80 percent of State WIC agencies (Exhibit 3-22). 

Although the percentages are generally few, some State WIC agencies do not retain any 

information on certain data elements. These include the participant’s second telephone number 

(19.5%), primary language (19.5%), proof of income shown if not adjunctively/automatically 

eligible (18.3%), and the value of the food package redeemed (12.2%). For some items, such as 

the program through which the participant was adjunctively income qualified and the 

participant’s address, the vast majority of State WIC agencies report they do retain the 

information in their records. 

It is worth noting that the lack of retention of participant data items at the State level does not 

necessarily mean the data are not kept. Rather, it could mean that these items are retained at the 

local agency or clinic levels. 

Exhibit 3-22: Storage of Selected Data about Participants 

Selected data items 

(n=82) 

State does not 

retain this 

information 

% 

State stores only 

most current 

information 

% 

State stores current and 

previous information for 

over 1 year 

% 

Participant name N/A 14.6 85.4 

Clinic attended 8.5 6.1 85.4 

Family identification or affiliation 2.4 12.2 85.4 

Category of eligibility 3.7 3.7 92.7 

Participant address 2.4 15.9 81.7 

Participant telephone number 2.4 18.3 79.3 

Second participant telephone number 19.5 13.4 67.1 

Food package issued 4.9 2.4 92.7 

Value of food package redeemed* 12.2 1.2 85.4 
Volume 2: State and Local Agencies (Final Report)

 30 National Survey of WIC Participants II 

Selected data items 

(n=82) 

State does not 

retain this 

information 

% 

State stores only 

most current 

information 

% 

State stores current and 

previous information for 

over 1 year 

% 

Program through which adjunctively/ 

automatically income eligible* 6.1 8.5 84.1 

Proofs of income shown (if not 

adjunctively/automatically eligible)* 18.3 7.3 73.2 

Primary language 19.5 14.6 65.9 

*Not shown in table: 1.2% of State WIC agencies responded that they retained this item for 4 to less than 12 months. 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

Agencies were also asked if proofs of eligibility were stored at the State WIC agency level. 

Each of the five different types of eligibility documents is kept at the State level by about 

one-third to two-fifths of the agencies (Exhibit 3-23). 

Exhibit 3-23: Proofs of Eligibility That Are Stored at the State Level 

Eligibility items 

(n=82) 

Total 

% 

Documents proving adjunctive/automatic eligibility 40.2 

Proofs of income 36.6 

Nutritional eligibility paperwork 35.4 

Proof of residency 34.1 

Categorical eligibility paperwork 32.9 

None of these 3.7 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

Recordkeeping at the Local Agency Level 

An issue related to State recordkeeping is the documentation that agencies must keep on file for 

the various proofs demonstrating the eligibility of participants at the certification stage including 

proofs for adjunctive/automatic or income eligibility, paperwork supporting nutritional and 

categorical eligibility, and documentation demonstrating proper residency. 

State WIC agencies were asked whether the local agencies under their jurisdiction are required to 

keep WIC participant data as original documents, retain copies of original documents, identify 

the number of original documents, or keep none of these items. As a general rule, original 

documents and/or copies of documents are not retained at the local agency; however, to a large 

degree, it depends on the type of eligibility item in question. For example, the original 

documents for nutritional eligibility are kept at the local agency in 40.2 percent of the State WIC 

agencies, but original documents for other types of eligibility proofs are kept at the local agency 

level by less than one-fifth of agencies. Copies of original documents are more common than 

original documents, except in the case of nutritional eligibility paperwork. 

The most widespread practice of recordkeeping required at the local-agency level is to have a 

note in the records indicating that the appropriate document was shown to the WIC staff person. 

Since State WIC agencies could check more than one way of storing data at the local-agency 
Volume 2: State and Local Agencies (Final Report)

 31 National Survey of WIC Participants II 

level, this practice could have been combined with other forms of document retention. The 

differences are described in Exhibit 3-24. 

Exhibit 3-24: Proofs of Eligibility That Local WIC Agencies 

Are Required To Keep in Their Files 

 Eligibility items 

(n=82) 

Original 

documents

% 

Copy of 

original 

documents

% 

Identifying 

number of 

original 

documents 

% 

A note in records 

indicating that 

document was 

shown to WIC staff 

% 

None of 

these 

items 

% 

Documents proving adjunctive/ 

automatic income eligibility 6.1 26.8 12.2 48.8 22.0 

Proofs of income eligibility 2.4 30.5 4.9 51.2 23.2 

Nutritional eligibility paperwork 40.2 14.6 1.2 26.8 25.6 

Categorical eligibility paperwork 19.5 18.3 3.7 36.6 28.0 

Proof of residency 2.4 28.0 4.9 52.4 23.2 

Note: Multiple responses were allowed, so totals do not equal 100%. 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

These days, the interval between the time when local agencies certify a participant and when 

they must send the information to the State WIC agency is very short. For reasons unclear, 

28.0 percent of State WIC agencies could not answer this question; however, of those who could, 

41.4 percent of State WIC agencies said that the data must be sent in real time or daily. This is 

compared with 28.0 percent of State WIC agencies who reported that the period is less than 

1 month and just 2.4 percent who claim it is more than 30 days. 
 32 National Survey of WIC Participants II 

CHAPTER 4. LOCAL WIC AGENCY FINDINGS

There are approximately 2,300 local WIC agencies nationwide, of which 503 were sampled and 

responded for this study. Nationally, FNS partners with the State WIC agencies to administer the 

WIC Program, and they, in turn, manage the local agencies. Therefore, the size, organizational 

structure, and management of local WIC agencies vary greatly, reflecting the preferences of each 

State WIC agency in running the program, even while adhering to National WIC Program 

regulations. To understand differences among agencies, their characteristics were studied in 

detail and the data analyzed with respect to the following: 

 Relationship of the local WIC agency to the parent State WIC agency, 

 Size of the whole agency (measured by participants served per month), and 

 Number of full-time staff. 

The vast majority (95.5%) of WIC local agencies nationwide have some direct dealings with 

WIC participants, although a small number (4.5%) are administrative offices only. This means 

that they oversee clinics that, in turn, certify WIC participants and provide services, but they do 

not perform these tasks themselves. Since a majority of the survey questions dealt with the 

characteristics of the client site, services offered to clients and capabilities, and agency 

procedures dealing with clients, the problem was handled by asking agencies that were purely 

administrative to answer these questions by selecting and answering for a “typical” clinic under 

their purview. 

4.1 Local Agency Size and Organization 

Local WIC agencies vary enormously in size. Counting the participants served at all the clinics, 

satellites, and mobile units within their jurisdiction, the local agencies that participated in the 

survey ranged in size from 58 participants per month to 309,000 per month at one unusually 

large urban agency.33 The average (median) number was 4,522 (4,307) participants served per 

month by the whole agency. This distribution is shown in Exhibit 4-1. For analysis purposes, the 

eight size categories were collapsed into four fairly equal groups defined, based on the number of 

participants per month: small (<750), medium (750 to ≤1,999), large (2,000 to ≤4,499), and very 

large (4,500+). 

 

33 The agency with 309,000 participants a month is an outlier. The second biggest local agency had less than one-third of this 

number, with 94,826 participants each month. Only six local agencies, including the outlier, had more than 80,000 participants 

a month. 
Volume 2: State and Local Agencies (Final Report)

 33 National Survey of WIC Participants II 

Exhibit 4-1: Distribution of Local WIC Agencies, by Participants per Month 

n=503 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

In describing their organizational relationship with the State WIC agency, almost half (44.6%) of 

the agencies describe themselves as a local government entity administering the WIC Program or, 

more rarely, a clinic under a local agency.34 The remainder consider themselves a part of the 

State WIC agency (29.3%) or could be classified as non-government organizations (26.2%), 

including non-profits, hospitals, health centers, and universities (Exhibit 4-2). 

Exhibit 4-2: Organizational Relationship of Local Agency to State WIC Agency 

Part of State agency

29.3 %

Non-government

organization

26.2 %

Local government

entity 

41.9% Local

government

44.6%

WIC clinic

2.7%

n=503 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

 

34 As noted earlier, if local agencies served as a purely administrative office, they were asked to answer questions pertaining to 

the local agency site based on a “typical clinic” under their jurisdiction. 
Volume 2: State and Local Agencies (Final Report)

 34 National Survey of WIC Participants II 

The distinction in how the local WIC agency program is administered is valuable in interpreting 

differences among agencies. To facilitate reference to these different administrative relationships in 

the reporting, these groups are here on referred to as State-affiliated agencies, Local government 

agencies, and Non-government agencies. 

There were sizable differences in participants served between the three types of agencies for 

reasons that are not immediately evident.32 State-affiliated agencies are about half the size of local 

government WIC agencies, which in turn are much smaller than non-government agencies 

(Exhibit 4-3). ITO local agencies were split evenly between being an affiliate of the State Agency 

and being a non-profit operating for the State Agency. 

Exhibit 4-3: The Relationship of Local WIC Agency to State WIC Agency, 

by Participants Served 

Organizational relationship of local agency to State WIC agency 

State-affiliated 

(n=136) 

Local government 

(n=219) 

Non-government 

(n=148) 

Average number of participants served 

per month by whole local agency*** 1,555 3,071 3,753 

Note: The difference between categories is statistically significant at the ***p < .0001 level; **p < .001 level; *p < .05 level. 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

In addition to the main site, local agencies were asked about other clinics, satellites, and mobile 

units under the authority of their agency. Clinics were defined as a permanent location while 

satellites were defined as a location such as a school, church, or town hall that is only 

temporarily assigned the WIC Program each week and to which staff must carry their own files 

and equipment. A mobile unit was defined as a vehicle assigned to the WIC Program that makes 

multiple stops. 

As seen in Exhibit 4-4, the majority of local agencies (84.2%) have clinics; a sizeable number 

also have satellites (31.6%); and very few have mobile units (2.6%). Non-government agencies 

were more likely to have mobile units than other types of agencies; however, this could be partly 

a function of size, since these agencies overall tend to serve more WIC participants. Although 

the average number of clinics, satellites, and mobile units vary some by type of agency, the 

median numbers were the same regardless of agency type. 

The number of clinics per local agency ranged from 0 to 37, with the exception of the one very 

large outlier agency that had 60 clinics. The average number of clinics for all agencies was 3; 

the median was 2. 

The number of satellites ranged from 0 to 24, with the exception of the one medium rural outlier 

agency that operated 37. The average number of satellites for all agencies was 3.6. The median 

was 0, meaning that over half of the agencies had no satellites. 

Finally, the number of mobile clinics ranged from 0 to 6, which averages less than 1 per local 

agency. The median was 0, indicating that over half of agencies had no mobile clinics. 
Volume 2: State and Local Agencies (Final Report)

 35 National Survey of WIC Participants II 

Exhibit 4-4: Relationship of Local WIC Agency to Clinics, Satellites, and Mobile Units 

Characteristics of Local WIC Agencies: 

Relationship of Local agency to State WIC agency 

Total 

(n=503) 

State affiliated

(n=136) 

Local government

(n=219) 

Non-government 

(n=148) 

Percentage having clinics (>0%)* 79.9% 83.3% 90.6% 84.2% 

 Average/Median number of clinics*** 5.0 / 2.0 2.6 / 2.0 3.5 / 2.0 3.4 / 2.0 

Percentage having satellites (>0%)*** 19.1% 31.4% 45.9% 31.6% 

 Average/Median number of satellites** 3.1 / 0.0 2.9 / 0.0 4.7 / 0.0 3.6 / 0.0 

Percentage having mobile units (>0%)*** 1.4% 1.2% 6.4% 2.6% 

 Average/Median number of mobile units 1.0 / 0.0 2.0 / 0.0 1.1 / 0.0 1.3 / 0.0 

Note: The difference between categories is statistically significant at the ***p < .0001 level; **p < .001 level; *p < .05 level. 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

Capabilities of Local Agencies Overall 

By and large, the main site of the local agencies seems well equipped. As seen in Exhibit 4-5, 

over 90 percent are able to conduct certifications and nutrition counseling, provide referrals for 

other services, take anthropometric measurements, access WIC participant data electronically, 

and distribute food checks. Most agencies can also perform blood testing and offer educational 

seminars; however, these numbers are a bit lower. Storing paper copies of WIC participants 

records ranks at the bottom and is now lower than maintaining electronic copies of WIC 

participant records—a reflection of changing technology. 

Exhibit 4-5: Capabilities of Local WIC Agencies at the Main Site 

Capabilities of agencies 

Total 

(n=503) 

% 

Conducts certifications 97.4 

Conducts nutrition counseling (individual and/or group) 95.7 

Provides referrals to health and other social services 95.3 

Takes anthropometric measurements for height, weight, and body mass index (BMI) 94.6 

Has access to WIC participant records electronically 92.4 

Distributes food checks 92.3 

Performs blood testing 86.1 

Offers other educational seminars (e.g., on breastfeeding) 80.9 

Stores paper copies of the WIC participant records 74.1 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

Even though clinics, satellites, and mobile units are subsidiary to the main local agency, it 

appears that they have most of the capabilities of the main local WIC agency. Exhibit 4-6 shows 
Volume 2: State and Local Agencies (Final Report)

 36 National Survey of WIC Participants II 

that clinics especially are almost at the same level as the main site; satellites and mobile units are 

close behind. 

 For all the capabilities measured, at least 80 percent of local agencies with clinics 

reported that “all” of them could perform the tasks. 

 Similarly, at least 80 percent of those with satellites and/or mobile units also reported that 

“all” of them could conduct the tasks, with two key exceptions: (1) educational seminars 

and (2) storage of paper copies of WIC participant records. 

 Reflecting the technological advances as well as agency progress, large numbers of local 

agencies reported that “all” their satellite offices and/or mobile units are able to access 

participant records electronically (85.4% and 80.2%, respectively). 
Volume 2: State and Local Agencies (Final Report)

 37 National Survey of WIC Participants II 

Exhibit 4-6: Capabilities of Clinics, Satellites, and Mobile Units 

n=503 

Source: National Survey of WIC Participants II: State and Local Agencies Report 
Volume 2: State and Local Agencies (Final Report)

 38 National Survey of WIC Participants II 

Nutrition Services and Administration Funds 

With the exception of the direct cost of the food, virtually all of the clinic functions described 

above are supported by Nutrition Services and Administration (NSA) funds. These funds, 

distributed by FNS, are vital to local WIC agencies, and they largely pay for participant 

assessments, equipment, nutrition education and materials, breastfeeding education and support, 

staff, clinic space, management information systems, referrals to health and social services, 

program outreach, printing of food checks, and vendor management. 

As vital as these services are to the functioning of the WIC Program, many local agencies had 

trouble answering a question about the distribution and average allocation of NSA funds among 

four activities (1) certification and recertification; (2) nutrition education; (3) breastfeeding 

promotion and support; and (4) administration. After many inquiries, local agencies were 

allowed to skip the question, which 111 of them did—22 percent of the unweighted sample. 

Of those that answered the question, the largest share of funds, on average, is attributed to 

certification and nutrition education, which together, amount to about two-fifths of NSA fund 

allocation. Over one-fourth (26.8%) is spent on nutrition education, with the rest shared about 

equally between program administration and breastfeeding services (Exhibit 4-7). 

Exhibit 4-7: Allocation of NSA Funds to Local WIC Agencies 

Allocation of NSA funds 

Total average 

 (n=392) 

% 

Certification and recertification 41.2 

Nutrition education 26.8 

Breastfeeding promotion and support 14.3 

Program administration 17.7 

Total 100.0 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

4.2 Participant Profile 

In describing the typical profile of WIC participants served, local agencies reported that the 

participants are comprised mostly of children (48.5%) and infants (23.1%), with women (28.4%) 

comprising nearly one-third of the population (12.8% pregnant, 9.0% postpartum, and 6.7% 

breastfeeding) (Exhibit 4-8). 

The findings on the participant profile reported here are similar to those reported in the 

Participant Characteristics volume35, which showed 51.9 percent children, 24.3 percent infants, 

and 10.5 percent pregnant, 7.0 percent postpartum, and 6.4 percent breastfeeding women. This is 

as expected and is reassuring in terms of both the reporting by agencies, and the comparability of 

different samples and their weighting. 

 

35 U.S. Department of Agriculture, Food and Nutrition Service; ICF International. (2012). National Survey of WIC Participants II 

(Volume 1: Participant Characteristics). 
Volume 2: State and Local Agencies (Final Report)

 39 National Survey of WIC Participants II 

Exhibit 4-8: Profile of Local Agency Participants, by Category, 

as Reported by Agency 

n=503 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

With respect to the demographic characteristics of the participants, agencies reported serving 

participants of various racial and ethnic backgrounds, with the diversity of clientele increasing 

directly with the size of the agency (Exhibit 4-9). On average, the overall WIC participant 

population reported by local WIC agencies is 60.6 percent White, 18.8 percent African American, 

and 10.7 percent multiracial, with other groups constituting only a small percentage of the 

participants. Specifically, 5.9 percent are American Indian/Alaska Native, 12.8 percent are 

Asian American, and 1.2 percent Native Hawaiian or other Pacific Islander (Exhibit 4-9). Local 

agencies report an average of 26.0 percent Hispanic or Latino participants. 

The larger the agency, the more racially diverse the participants’ profile. The percentage of 

White participants drops from 65.1 percent in small agencies to 53.7 percent in the large ones, 

while the percentage of participants in other racial categories increases. 

The percentage of Hispanics also rises dramatically with increased agency size, from just 

17.4 percent among small agencies to 39.2 percent in the larger ones. 

Local agencies estimate similar levels of migrants and homeless participants on average (2.0% 

and 1.7%, respectively). Small agencies (<750 participants per month) reported the fewest 

migrants and homeless participants on average. Among the other groups, as might be expected, 

migrant participants are represented more heavily in medium size agencies—which tend to be in 

less populated or rural areas—while homeless participants are much more prevalent in large and 

very large agencies—which tend to be more urban. 

12.8%

6.7%

9.0%

23.1%

48.5%

Pregnant

Breastfeeding

Postpartum

Infants

Children
Volume 2: State and Local Agencies (Final Report)

 40 National Survey of WIC Participants II 

Exhibit 4-9: Characteristics of WIC Participants Served, by Agency Size 

Average percentage 

Participants served at the whole agency 

(administrative data) 

Total 

(n=503)

% 

<750 

(n=43) 

% 

750–1,999 

(n=96) 

% 

2,000–4,499

(n=120) 

% 

4,500+ 

(n=244) 

% 

Hispanic or Latino*** 17.4 20.0 28.6 39.2 26.0 

Not Hispanic or Latino*** 82.6 80.0 71.4 60.8 74.0 

Total 100.0 100.0 100.0 100.0 100.0 

American Indian or Alaska Native 7.1 5.8 5.2 5.3 5.9 

Asian American*** 0.7 1.6 4.1 4.8 2.8 

Black or African American* 13.8 18.3 21.0 22.5 18.8 

Native Hawaiian or other Pacific Islander* 0.2 0.7 2.0 2.0 1.2 

White** 65.1 65.9 56.7 53.7 60.6 

Multiracial36 13.1 7.6 11.0 11.6 10.7 

Total 100.0 100.0 100.0 100.0 100.0 

Migrant farm workers 0.3 3.8 1.8 2.0 2.0 

Homeless** 0.4 1.8 1.9 2.7 1.7 

Note: The difference between categories is statistically significant at the ***p < .0001 level; **p < .001 level; *p < .05 level. 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

4.3 Staff and Participant Caseload 

In addition to providing food packages, the WIC Program is about delivering services, whether it 

is certifying applicants for WIC, assessing their nutritional status, offering breastfeeding 

counseling, referring participants to health and other social services, or conducting nutrition 

education. As such, the staff and participant caseload at agencies is extremely important to the 

functioning of the program. 

Staff Levels 

To determine staffing levels, employee profiles, and staff turnover at local WIC agencies, 

agencies were asked to provide data for their staff. This included the number of full-time staff by 

position, number of part-time staff by position, the number of staff who had worked at the 

agency less than 2 years, and an estimate of total full-time equivalent (FTE) staff. The latter 

calculation was to be made, as respondents were instructed, by combining the hours of part-time 

employees to estimate the FTE. Local agencies were asked to list the positions for which they 

experienced staffing shortages and identify the difficulties they face in retaining, recruiting, and 

hiring staff. 

 

36 Multiracial includes any combination of more than one race but does not include Other or Don’t Know. 
Volume 2: State and Local Agencies (Final Report)

 41 National Survey of WIC Participants II 

On average, local agencies employ 17.9 FTE staff members. Not surprisingly, the larger the 

agency, the more staff they have. Accordingly— 

 Small agencies (<750 participants/month) have an average of 10.2 FTE employees; 

 Medium-size agencies (750–1,999 participants/month) have 11.7 FTE employees; 

 Large agencies (2,000–4,499 participants/month) have 12.4 FTE employees; and 

 The very large agencies (4,500+ participants/month) have 37.9 FTE employees. 

Given that State-affiliated local agencies have the smallest average number of participants and 

non-government agencies have the largest, one would have expected them to have the 

corresponding numbers of employees, respectively. However, as Exhibit 4-10 shows, that is not 

the case. State-affiliated agencies reported the largest number of FTE employees of all, with 21.2, 

while non-government agencies reported 18.6. The data are counterintuitive; the problem probably 

stems from the confusion regarding the question. Presumably, large agencies—despite being 

instructed to report the staff for the whole agency—seemed to answer for just the main site of the 

local agency. 

Exhibit 4-10: Number of WIC Agency Full-Time Equivalent Staff, 

by Local WIC Agency Type and Agency Size 

FTE staff 

Relationship of Local agency to State 

WIC agency 

Participants served at the whole 

agency (administrative data) 

Total

(n=503)

% 

Stateaffiliated 

(n=136) 

% 

Local 

government

(n=219) 

% 

Nongovernment

(n=148) 

% 

<750

(n=43)

% 

750–

1,999

(n=96)

% 

2,000–

4,499 

(n=120) 

% 

4,500+

(n=244)

% 

The number of 

FTE staff * 

<5 29.7 36.8 22.9 74.6 41.1 3.4 1.1 31.1 

5 to 9 28.8 26.1 28.8 10.9 43.1 52.3 4.1 27.6 

10 to 20 16.1 18.8 24.4 3.8 7.6 36.0 33.3 19.5 

>20 25.3 18.3 24.0 10.8 8.2 8.3 61.4 21.9 

Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 

In all, what is the number of FTE 

staff who work at your local 

WIC agency or clinic?*/*** 

21.2 15.4 18.6 10.2 11.7 12.4 37.9 17.9 

Note: The difference between categories is statistically significant at the ***p < .0001 level; **p < .001 level; *p < .05 level. 

Source: National Survey of WIC Participants II: State and Local Agencies Report 
Volume 2: State and Local Agencies (Final Report)

 42 National Survey of WIC Participants II 

Assessing specific positions agency-wide, the most commonly reported full-time positions are 

as follows: 

 Directors (68.4%), 

 Administrative support staff (62.5%), 

 Nutritionists (53.9%), 

 Dietitians (47%), and 

 Nurses/physician assistants (31.6%). 

Other WIC staff positions—such as office manager, certification specialists, other non-medical 

professions—are employed full-time by less than one-fourth of the agencies. Physicians, social 

workers, psychologists, and therapists are the least likely to be employed by the local agencies 

(less than 3%) (Exhibit 4-11). Not surprisingly, there is a strong upward trend in the percentage 

of agencies filling full-time positions as an agency size increases. 

The average number(s) and types of full-time and part-time positions are shown in Exhibit 4-12, 

both in aggregate and by agency size. 
Volume 2: State and Local Agencies (Final Report)

 43 National Survey of WIC Participants II 

Exhibit 4-11: Percentage of Agencies with Full-Time Staff Positions, by Agency Size 

(with Average Number of Part-Time Staff in Parentheses) 

43.3

15.5

40.7

14.7

14.1

15.4

0.0

40.4

3.5

5.3

3.8

7.4

59.3

20.6

56.9

17.6

34.3

43.9

2.0

38.9

1.9

1.9

7.2

7.3

80.1

21.9

69.1

20.7

60.8

73.0

2.3

22.8

0.0

0.7

13.4

18.5

93.3

46.9

85.1

24.2

81.9

86.9

7.9

22.8

0.7

0.4

19.2

33.2

68.4

26.1

62.5

19.2

47.0

53.9

3.0

31.6

1.6

2.1

10.7

16.3

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Director or Clinic 

Supervisor***/**

Office Manager***

Admin. Support***

Certif. Specialist*

Registered Dietitian***

Nutritionist

Peer Counselor

Nurse/Physician Asst.*/***

Physician

Social Worker/Therapist

Other Non-Med. Prof'l.**

Other***

Small <750 Medium 750-1,999 Med-Large 2,000-4,500 Large >4,500 Total

(28.0)

(20.8)

(12.2)

(8.2)

(17.6)

(11.5)

(7.8)

(4.2)

(3.8)

(6.9)

(30.9)

(31.8)

(24.5)

(26.6)

(28.6)

(15.7)

(4.7)

(7.2)

(7.2)

(8.6)

(42.4)

(31.6)

(37.1)

(31.8)

(35.6)

(33.8)

(26.8)

(32.3)

(28.6)

(30.3)

(5.3)

(9.2)

(10.4)

(10.8)

(8.9)

(39.9)

(28.1)

(16.9)

(8.8)

(23.8)

(0.0)

(0.0)

(0.9)

(1.5)

(0.6)

(0.0)

(1.9)

(1.7)

(0.6)

(1.0)

(6.1)

(3.7)

(9.2)

(9.7)

(7.0)

% Part-time

(11.9)

(15.1)

(11.2)

(14.1)

(13.1)

Percentage

Note: The difference between categories is statistically significant at the ***p < .0001 level; **p < .001 level; *p < .05 level. 

n=503 

Source: National Survey of WIC Participants II: State and Local Agencies Report 
Volume 2: State and Local Agencies (Final Report)

 44 National Survey of WIC Participants II 

Exhibit 4-12: Average Number of Full-Time Staff, by Agency Size 

(with Average Number of Part-Time Staff in Parentheses) 

5.9

4.3

5.6

1.9

6.7

3.2

4.2

3.2

7.4

5.7

3.0

1.7

9.2

5.9

1.0

1.3

6.8

4.2

6.6

4.9

10.7

8.6

2.7

2.5

2.9

4.2

1.0

0.0

3.8

1.7

2.5

1.8

4.9

3.8

2.5

1.1

1.9

2.0

8.0

2.0

6.4

1.0

2.1

1.7

3.0

4.9

4.1

1.7

2.7

1.0

5.6

2.0

8.3

0.0

2.0

2.0

10.9

4.0

2.7

1.0

0% 5% 10% 15%

Other 

Other Non-Med. Prof'l.

Social Worker/Therapist

Physician

Nurse/Physician Asst.

Peer Counselor 

Nutritionist 

Registered Dietitian 

Certif. Specialist 

Admin. Support 

Office Manager 

Director or Clinic Supervisor

Percentage

Small <750 Medium 750-1,999 Med-Large 2,000-4,500 Large >4,500 Total

(1.0)

(1.0)

(1.0)

(1.1)

(1.0)

(1.3)

(1.0)

(1.0)

(1.2)

(1.1)

(1.9)

(2.7)

(2.3)

(2.3)

(2.3)

(1.4)

(2.0)

(1.5)

(3.1)

(1.9)

(1.6)

(1.3)

(2.5)

(2.1)

(1.8)

(1.0)

(1.3)

(1.4)

(1.8)

(1.3)

(1.4)

(4.2)

(2.8)

(3.0)

(3.0)

(1.9)

(3.2)

(1.8)

(3.2)

(2.4)

(0.0)

(2.0)

(1.0)

(1.2)

(1.4)

(0.0)

(1.0)

(3.0)

(1.0)

(1.8)

(1.0)

(2.1)

(1.7)

(2.6)

(1.9)

(1.7)

(1.4)

(1.9)

Number of Part-time

n=503 

Source: National Survey of WIC Participants II: State and Local Agencies Report 
Volume 2: State and Local Agencies (Final Report)

 45 National Survey of WIC Participants II 

Staffing Issues 

The majority of the local agencies (52.6%) have staffing shortages to some degree with 

registered dietitians, administrative support, nutritionists, and nurses/physician assistants being in 

the greatest need (Exhibit 4-13). Larger agencies exhibit a higher degree of staffing shortages 

(63.5%) than smaller agencies (45.2%). State-affiliated agencies are the most likely to report 

staffing shortages (65.1%), followed by non-government agencies (53.5%), and local WIC 

government agencies (43.9%). 

Exhibit 4-13: Local WIC Agencies with Staffing Shortages, by Agency Size 

LA’s with shortages of: 

Participants served at the whole agency (administrative 

data) 

Total 

(n=503) 

% 

<750 

(n=43) 

% 

750–1,999 

(n=96) 

% 

2,000–4,499

(n=120) 

% 

4,500+ 

(n=244) 

% 

Registered licensed dietitian 20.4 19.7 32.4 36.2 26.9 

Administrative/clerical/support staff 17.5 22.0 16.9 19.4 19.1 

Degreed/licensed nutritionist 11.9 12.4 21.1 25.1 17.4 

Registered nurse/physician assistant*** 20.8 13.7 1.5 5.7 10.7 

Trained nutrition paraprofessional* 1.9 9.3 10.4 14.2 8.9 

Social worker/psychologist/therapist -- 1.1 2.6 1.3 1.2 

Other professional -- 1.0 2.6 0.7 1.1 

Physician -- 1.7 1.6 -- 0.9 

Other -- 4.2 9.3 11.3 6.0 

No staffing shortages* 54.8 52.9 44.2 36.5 47.4 

Yes—Have staffing shortages* 45.2 47.1 55.8 63.5 52.6 

Note 1: Multiple responses were allowed, so totals do not equal 100%. 

Note 2: The difference between categories is statistically significant at the ***p < .0001 level; **p < .001 level; *p < .05 level. 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

More than three-fourths of the local agencies (78.2%) reported having difficulties recruiting and 

retaining staff (Exhibit 4-14). The top three challenges for agencies pertain to limited salaries 

(54.0%), limited career opportunities (40.4%), and heavy workload (23.5%). These problems 

affect all sizes of agencies. Issues such as benefits, physical space, skill set of prospective 

employees and minimal training/job growth opportunities were named as problems by less than 

one-fifth of local agencies, while the location and safety of the agency were cited by less than 

one-tenth of the agencies. 

Non-government agencies were more likely than other types of agencies to list the lack of 

required skills in prospective employees (27.7%), uncompetitive benefits (25%), and hard-toreach locations (12%). State-affiliated agencies were the most likely to report low employee 

morale (18.4%). 

Larger agencies are more likely to report staffing difficulties in virtually all areas. 
Volume 2: State and Local Agencies (Final Report)

 46 National Survey of WIC Participants II 

Exhibit 4-14: Challenges to Retaining, Recruiting, and Hiring Staff, by Agency Size 

Challenges 

Participants served at the whole agency 

(administrative data) 

Total 

(n=503) 

% 

<750 

(n=43) 

% 

750–1,999 

(n=96) 

% 

2,000–4,499

(n=120) 

% 

4,500+ 

(n=244) 

% 

Salaries not competitive 43.5 55.1 56.4 61.4 54.0 

Limited career path or opportunities for 

promotion*** 15.5 39.6 47.9 59.7 40.4 

Workload too great 15.8 21.5 27.9 29.7 23.5 

Required skill set lacking in prospective 

employees 14.9 20.3 17.4 21.5 18.6 

Benefits not competitive 12.0 13.5 13.3 16.8 13.9 

Physical space occupied by local agency 

crowded** 6.7 9.6 14.3 25.6 13.8 

Minimal training and job growth offered 4.6 15.8 17.8 15.3 13.3 

Low employee morale throughout agency 9.1 9.4 9.2 12.6 10.0 

Lack of support for WIC Program from 

State WIC agency 6.0 6.9 8.0 8.6 7.3 

Location of local agency hard to get to 6.2 5.9 5.6 5.3 5.8 

Location of local agency unsafe -- 1.1 3.4 3.2 1.9 

Other 14.0 7.4 9.8 13.9 11.2 

None of the above (no staffing difficulties)** 33.6 22.9 21.4 8.7 21.8 

Have staffing difficulties** 66.4 77.1 78.6 91.3 78.2 

Note 1: Multiple responses were allowed, so totals do not equal 100%. 

Note 2: The difference between categories is statistically significant at the ***p < .0001 level; **p < .001 level; *p < .05 level. 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

Language Capabilities 

Language capabilities of local agencies were assessed vis-à-vis the needs of the WIC population. 

Participants who do not speak English well enough to communicate about eligibility, procedures, 

nutrition, breastfeeding, and services were reported in 86.0 percent of agencies. 

 This number was lower among small agencies, only 56.8 percent of whom say they have 

some participants who cannot communicate in English, and higher among medium 

(92.3%), large (96.3%) and very large (99.5%) agencies. 

 By type of agency, the differences were less great, with 83.2 percent of local government 

agencies, 86.0 percent of non-government agencies; and 90.4 of State-affiliated agencies 

saying they see clients who cannot communicate in English. 

 
Volume 2: State and Local Agencies (Final Report)

 47 National Survey of WIC Participants II 

The breakdown for agencies overall is shown in Exhibit 4-15. 

Exhibit 4-15: Percentage of WIC Participants 

Who Cannot Communicate in English 

14.0%

32.0%

11.2%

9.7%

18.7%

8.1%

6.3%

0% of clients

1-5% of clients

6-10% of clients

11-20% of clients

21-40% of clients

41-60% of clients

61-100% of clients

Percentage who can't 

speak English:

n=503 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

To meet specific language needs, the vast majority of the agencies (84.1%) reported offering 

services in foreign languages (Exhibit 4-16). Spanish is, by far, the most frequently offered 

language (70.5%), with others offered by 10 percent or less of agencies. The type of agency does 

not have a strong relationship with the use of foreign languages. However, very large agencies 

(>4,500 participants/month) are far more likely to offer services in foreign languages (97.9%), 

compared with small agencies (<750 participants/month) (69.6%). The very large agencies are 

especially more likely to provide Spanish (93.8%) compared to the small agencies (51.4%). 
Volume 2: State and Local Agencies (Final Report)

 48 National Survey of WIC Participants II 

Exhibit 4-16: Foreign Languages Offered by Local WIC Agency Staff 

(in Descending Order) 

70.5

27.1

10.3

8.7

7.8

7.5

7.1

6.7

6.5

5.9

5.9

5.6

5.1

4.3

4.3

4.2

4.0

3.6

3.4

3.3

2.2

2.2

15.9

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Spanish

Various other languages

French/Creole

Vietnamese

Cantonese/Mandarin

Tagalog

Arabic

Russian

Portuguese

Korean

Hindi

Hmong

Laotian

Somali

Cambodian

Farsi

Urdu

Khmer

Punjabi

Swahili

Tamil

Fulani

NONE OFFERED

Percentage

n=503 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

Despite the prevalence of foreign language offered, more than one-third (37.3%) of the agencies 

related having some participants who are not served by the languages offered. The average 

percentage of the participants in this category is small (3.3%) and few agencies (4.1 %) have 

more than 10 percent of the participants not served (Exhibit 4-17). 

 The type of agency does not have a strong relationship to the type of participants not 

being served by language capabilities. 

 However, size of agency does have some influence. Very large agencies are the most 

likely to have participants who are not served (53.9%), followed by large agencies 

(45.9%), medium (37.7%) and small (12.7%). 

 It is noteworthy that among agencies reporting these language needs, medium size 

agencies estimated the highest average percentage of participants not being served (6.4%). 

Apparently their internal staff language capabilities are low relative to the need. 
Volume 2: State and Local Agencies (Final Report)

 49 National Survey of WIC Participants II 

Exhibit 4-17: WIC Participants Not Being Served by Language Capabilities, 

by Agency Size 

Local Agencies having: 

Participants served at the whole agency 

(administrative data) 

Total 

(n=503) 

% 

<750 

(n=43) 

% 

750–1,999 

(n=96) 

% 

2,000–4,499

(n=120) 

% 

4,500+ 

(n=244) 

% 

WIC population (applicants, participants, and 

proxies) who are not served, by combined 

language capabilities*** 

12.7 37.7 45.9 53.9 37.3 

More than 10% of WIC population (applicants, 

participants, and proxies) who are not served, 

by combined language capabilities 

1.5 7.3 4.9 2.7 4.1 

Average percentage of WIC population 

(applicants, participants, and proxies) who are 

not served, by combined language capabilities 

0.6 6.4 3.3 2.9 3.3 

Note: The difference between categories is statistically significant at the ***p < .0001 level; **p < .001 level; *p < .05 level. 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

Among the 4.1 percent of the agencies that have more than 10 percent of participants who are not 

served by language capabilities, a question was posed about which languages the agency needs 

further support. This subset of agencies reported that the top five languages are Spanish (59.4%), 

Vietnamese (26.2%), Korean (21%), Arabic (14.6%), and Swahili (13.3%) (Exhibit 4-18); the 

other languages are needed by 12.0 percent or fewer local agencies. 

Of the local agencies with over 10 percent of participants not served, the larger ones are the most 

likely to need a range of languages, especially Spanish (47.3%). These results should be 

interpreted with caution, because they are based on a very small subsample of local agencies. 

Exhibit 4-18: Languages the Local WIC Agency Staff Needs 

To Serve the WIC Population, by Agency Size 

Languages 

Participants served at the whole agency 

(administrative data) 

Total 

(n=21) 

% 

<750 

(n=1) 

% 

750–1,999 

(n=7) 

% 

2,000–4,499

(n=6) 

% 

4,500+ 

(n=7) 

% 

Spanish 100.0 81.1 14.9 47.3 59.4 

Vietnamese 100.0 -- 43.1 33.3 26.2 

Korean 100.0 -- 38.1 9.2 21.0 

Arabic -- -- 34.3 33.3 14.6 

Swahili -- 15.8 15.6 9.2 13.3 

Somali -- -- 30.5 23.2 12.0 

Farsi -- -- 15.6 33.3 9.5 

French/Creole -- -- 14.9 33.3 9.3 

Cambodian -- -- -- 57.3 9.0 
Volume 2: State and Local Agencies (Final Report)

 50 National Survey of WIC Participants II 

Languages 

Participants served at the whole agency 

(administrative data) 

Total 

(n=21) 

% 

<750 

(n=1) 

% 

750–1,999 

(n=7) 

% 

2,000–4,499

(n=6) 

% 

4,500+ 

(n=7) 

% 

Cantonese/Mandarin -- -- 18.7 9.2 6.6 

Punjabi -- -- -- 33.3 5.2 

Hindi -- -- -- 33.3 5.2 

Urdu -- -- -- 33.3 5.2 

Portuguese -- -- -- 31.7 5.0 

Other -- -- 23.2 38.1 12.3 

Note: Percentages were calculated for cases with more than 10% of the WIC population (applicants, participants, and proxies) not 

served, by combined language capabilities. Multiple responses were allowed, so totals do not equal 100%. 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

4.4 Characteristics of the Local Agency Primary Site 

Data were gathered about the physical facility and operational details of the main local agency. 

This involved a series of questions pertaining to the site’s location, hours of operation, number of 

participants seen, physical structure, equipment and safety, as well as public/private 

transportation. All these factors play an important role in how the WIC Program is operated and 

how well it meets participants’ needs. 

Location and Operations 

As shown in Exhibit 4-19, almost three-fourths of local agencies’ main sites (73.6%) are located in 

health departments, health clinics, or health centers. In contrast, fewer are located in social service 

agencies (7.1%), hospitals (6.3%), or non-profit organizations (13.1%). The issue of site location is 

different from that of administration since non-government WIC agencies may lease space in 

government offices, local government agencies may operate from a health center, and so on. 

Small agencies (<750 participants) are more likely to be located in hospitals (11.8%)—such sites 

may serve mostly pregnant women—than are large agencies (6.7%) and very large agencies 

(4.6%). Meanwhile, very large agencies (4,500+ participants) are more likely to be sited in nonprofit organizations (21.6%) than are smaller agencies (decreasing with size to 3.5% for the 

smallest). Furthermore, small and medium agencies are more likely to be in health departments 

than are large and very large agencies (81.1% and 79.1% versus 66.5%). 
Volume 2: State and Local Agencies (Final Report)

 51 National Survey of WIC Participants II 

Exhibit 4-19: Location of Local WIC Agency Facilities, 

by Agency Type and Size 

Location of local agency or 

clinic facility 

Relationship of 

Local agency to State WIC agency***

Participants served at the whole 

agency (administrative data)* 

Total

(n=503)

% 

State 

affiliated 

(n=136) 

% 

Local 

government

(n=219) 

% 

Nongovernment

(n=148) 

% 

<750

(n=43)

% 

750–

1,999

(n=96)

% 

2,000–

4,499 

(n=120) 

% 

4,500+

(n=244)

% 

Health department, health 

center, or medical clinic 85.7 91.0 30.5 81.1 79.1 66.5 66.5 73.6 

Social services office, WIC, or 

other agency 9.7 3.4 10.4 3.5 8.1 9.5 7.4 7.1 

Full-service hospital or satellite -- 4.1 16.9 11.8 2.2 6.7 4.6 6.3 

Site of non-profit organization 4.7 1.4 42.2 3.5 10.7 17.3 21.6 13.1 

Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 

Note: The difference between categories is statistically significant at the ***p < .0001 level; **p < .001 level; *p < .05 level. 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

On average, the main sites of the local agencies are open 5 days a week for a total of 36 hours; 

small agencies reported just 4 days and a total of 31 hours per week. As a whole, local agencies 

estimate they serve an average of 2,805 participants per month at their site, which increases with 

agency size (239 for small, 823 for medium, 2,185 for large, and 8,251 for extra large). About 

half (48.3%) of the participants served at the agency sites were there for certifications or 

recertifications, with no appreciable differences by agency size (Exhibit 4-20). 

Exhibit 4-20: Operational Characteristics of Local WIC Agency Main Site, by Agency Size 

Characteristics 

Participants served at the whole agency (administrative 

data) 

Total 

(n=503) 

% 

<750 

(n=43) 

% 

750–1,999 

(n=96) 

% 

2,000–4,499

(n=120) 

% 

4,500+ 

(n=244) 

% 

Average number of days agency open to 

participants/applicants** 4.0 4.8 5.0 5.1 4.7 

Average number of hours per week that 

WIC agency is open*** 31.4 36.1 37.3 39.6 36.0 

Average number of hours per week that 

are extended hours (before 9 a.m. and 

after 5 p.m.)*** 

2.5 4.7 5.7 6.7 4.9 

Average number of participants served at 

this location of the agency per month*** 239.3 822.5 2185.4 8,250.8 2,804.9 

Average percentage of participants seen for 

certifications and recertifications 44.5 52.0 48.7 47.5 48.3 

Note: The difference between categories is statistically significant at the ***p < .0001 level; **p < .001 level; *p < .05 level. 

Source: National Survey of WIC Participants II: State and Local Agencies Report 
Volume 2: State and Local Agencies (Final Report)

 52 National Survey of WIC Participants II 

Physical Structure and Equipment 

With respect to the numbers and types of rooms at the main local agency site, virtually all 

agencies (96.0%) reported having rooms, offices, or cubicles where participants are seen, and the 

majority reported having large and small waiting rooms (68.4% and 52.0%, respectively) 

or administrative offices (51.3%). Less than half reported having large or small multipurpose 

rooms (41.0% and 43.8%, respectively), which has implications about an agency’s ability to hold 

group nutrition education sessions. 

The average number of rooms at the local agency site by number of participants seen at the main 

site is shown in Exhibit 4-21. As expected, agencies that see more participants at the main site 

reported a larger number of rooms. 

Exhibit 4-21: Average Number of Rooms at Local WIC Agency Site, by Agency Size (for 

Agencies with at least 1 such room/area) 

Characteristics 

Participants served at the whole agency 

(administrative data) 

Total 

(n=503) 

<750 

(n=43) 

% 

750–1,999 

(n=96) 

% 

2,000–4,499

(n=120) 

% 

4,500+ 

(n=244) 

% 

Large waiting rooms/reception areas 

(greater than 15 x 15 feet)** 1 1.2 1.2 2.1 1.4 

Small waiting rooms/reception areas 

(15 x 15 feet or smaller)** 1.1 1.2 1.1 2 1.4 

Rooms, offices, or cubicles where 

participants are seen*** 2.7 4.3 6.4 10.2 5.8 

Large training/conference/multipurpose 

rooms 1.1 1.1 1.1 1.7 1.3 

Small training/conference/multipurpose 

rooms** 1.2 1.2 1.1 2.1 1.4 

Administrative offices (no participants 

seen)*** 1.4 1.5 1.8 2.7 2 

Administrative cubicles (no participants 

seen)** 2 2.1 3.1 3.9 3 

Other: Please specify* 1.7 2 2.2 4.2 2.6

Note 1: Averages were calculated for cases with valid data (>0). 

Note 2: The difference between categories is statistically significant at the ***p < .0001 level; **p < .001 level; *p < .05 level. 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

Local agencies were asked about their computer infrastructure at the main agency site and their 

ability to perform certain basic medical assessments requiring specialized equipment. Virtually 

all local agencies (98.2%) reported having the ability to enter and access participant information 

into computers for certifications (Exhibit 4-22). The large majority of local agencies also stated 

that their computers are networked to each other (83.1%) and to other agencies and/or the State 

WIC office (83.7%). Furthermore, almost all local agencies (93.7%) reported having Internet 

access. Small agencies are the least likely to have Internet access (90.1%), while the very large 

are the most likely to have web access (97.8%). 
Volume 2: State and Local Agencies (Final Report)

 53 National Survey of WIC Participants II 

Exhibit 4-22: Local WIC Agency Computer Resources 

Type of computer resource 

Total 

(n=503) 

% 

Ability to enter and access participant certification information via a computer 98.2 

Computer is networked to other computers in the office (i.e., a shared drive) 83.1 

Computer is networked to other agencies, clinics, or the State WIC office 83.7 

Have Internet access 93.7 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

Looking at other agency capabilities, an overwhelming majority of the agencies reported that 

they can perform hematological tests (89.2%), and all local agencies (100.0%) reported the 

ability to take anthropometric measurements for weight, body mass, and height. 

Safety and Transportation 

A very high number of the agencies (96.9%) believe that their location is safe or very safe, 

although the percentage of Very safe responses drops sharply with increase in the size of 

agencies, from 80.3 percent for the small agencies to 33.4 percent for very large ones (Exhibit 4-

23). Approximately 1 in 20 (5.8%) of very large local agencies feel their facility is unsafe or 

very unsafe. 

Exhibit 4-23: Physical Security of Local WIC Agency’s Main Location, by Agency Size 

Level of physical security 

Participants served at the whole agency 

(administrative data)*** 

Total 

(n=503) 

% 

<750 

(n=43) 

% 

750–1,999 

(n=96) 

% 

2,000–4,499 

(n=120) 

% 

4,500+ 

(n=244) 

% 

Very safe (no incidents) 80.3 63.8 47.6 33.4 56.8 

Safe (occasional minor incidents) 18.0 32.2 51.7 60.8 40.1 

Unsafe (occasional major incidents or 

frequent minor incidents) 1.7 3.1 0.7 5.3 2.7 

Very unsafe (frequent major incidents) -- 0.8 -- 0.5 0.4 

Note: The difference between categories is statistically significant at the ***p < .0001 level; **p < .001 level; *p < .05 level. 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

Participant Transportation 

Just over half of all agencies (55.6%) have public transportation within a 10-minute walk 

(or 1/2-mile distance) of their location; about half (45.9%) of all agencies reported having a bus 

within 1/2-mile distance; followed by light rail (7.7%) and other miscellaneous forms of public 

transportation (14.3%). The larger the agency, the more likely it is to have bus or light rail 

transportation nearby (Exhibit 4-24). However, smaller agencies are more likely to have access 

to other types of public transportation, although the exact nature of these was not specified. 
Volume 2: State and Local Agencies (Final Report)

 54 National Survey of WIC Participants II 

The overwhelming majority of agencies (91.8%) reported that participants are using private cars 

as the most frequent mode of transportation, followed by walking (46.2%). 

 The larger agencies (with at least 2,000 participants) were somewhat less likely to report 

private car as the primary mode of transportation (approximately 85%), compared with 

agencies that serve less than 2,000 participants (over 97%). 

Exhibit 4-24: WIC Participant Options and Methods of Transportation Used, 

by Agency Size 

Options and methods of transportation used 

Participants served at the whole agency 

(administrative data) 

Total 

(n=503)

% 

<750 

(n=43) 

% 

750–

1,999 

(n=96) 

% 

2,000–4,499 

(n=120) 

% 

4,500+ 

(n=244) 

% 

Public transportation within a 10-

minute walk (1/2 mile) of 

the agency*** 

Yes 29.2 38.0 75.3 83.9 55.6 

No 70.8 62.0 24.7 16.1 44.4 

Bus—within a 10-minute walk (1/2 mile) of the 

agency*** 9.2 24.9 72.7 82.2 45.9 

Light rail/subway/commuter train—within a 10–

minute walk (1/2 mile)* -- 2.4 11.9 17.5 7.7 

Other public transportation—within a 10-minute 

walk (1/2 mile)* 23.1 15.2 9.5 8.9 14.3 

Most frequent means of transportation used by WIC applicants and participants to get to agency 

Private car 98.5 97.1 84.7 85.8 91.8 

Taxi -- 0.8 1.6 0.5 0.7 

Bus 1.5 -- 8.1 7.9 4.2 

Light rail/subway/commuter train -- -- 1.6 1.5 0.7 

On foot -- 2.2 3.1 4.3 2.4 

Other -- -- 1.0 -- 0.2 

Second most used means of transportation used by WIC applicants and participants to get to agency 

Private car 1.5 1.3 5.9 7.4 3.9 

Taxi 3.4 9.9 6.1 7.5 6.8 

Bus 1.9 13.0 44.5 48.9 26.2 

Light rail/subway/commuter train -- -- 0.8 1.0 0.4 

On foot 73.4 47.0 31.5 31.0 46.2 

Other 19.8 28.8 11.2 4.1 16.4 

Note: The difference between categories is statistically significant at the ***p < .0001 level; **p < .001 level; *p < .05 level. 

Source: National Survey of WIC Participants II: State and Local Agencies Report 
Volume 2: State and Local Agencies (Final Report)

 55 National Survey of WIC Participants II 

4.5 Participant Services Offered at Main Local Agency Site 

On an aided basis, local agencies were asked if their main location provided services in 

19 specific areas—areas which had been identified as being among the services a WIC agency 

might offer.37 The participant services covered a broad range—from breastfeeding support to 

family planning to employment/life skills training. To assess capacity, agencies were asked the 

following question for each service they said they offered. 

For each of the following services, please indicate if your local agency is able to 

offer the service, provide information and/or make referrals in the following areas. 

“Ability to make a referral” means that your local agency’s involvement is 

required to obtain a particular service whereas “ability to provide information” 

means that you have only given client the information about the problem and 

possibly places to go for help. (CHECK ALL THAT APPLY)

a. Offered by WIC Agency/Clinic 

b. Ability to provide information 

c. Ability to make referrals 

d. Neither 

Of all the services offered by the local WIC agency itself, breastfeeding support was the most 

frequently offered service (96.7%), followed by nutrition services (91.2%), prevention and 

screenings (e.g. vision or Early & Periodic Screening, immunizations) (62.7%), sexually 

transmitted diseases (STD) services (46.0%), and family planning (44.6%) (Exhibit 4-25). 

 Larger agencies were less likely than smaller ones to offer services themselves in areas of 

prevention and screenings, STD services and family planning. 

 Differences by type of local agency mirror the patterns shown by size. That is, since 

State-affiliated agencies have the smallest average size, local government agencies are 

medium-size, and non-government agencies are the largest, their patterns of services 

reflect their size category. 

Exhibit 4-25: Most Frequently Offered Services at Local WIC Agency, by Agency Size 

Services provided 

Participants served at the whole agency 

(administrative data) 

Total 

(n=503)

% 

<750 

(n=43) 

% 

750–1,999

(n=96) 

% 

2,000–4,499 

(n=120) 

% 

4,500+ 

(n=244) 

% 

BREASTFEEDING SUPPORT 

Offered by WIC Agency/Clinic itself 100.0 94.0 96.6 96.5 96.7 

Able to provide information 26.6 24.1 30.2 27.9 27.1 

Able to make a referral 13.0 7.8 20.4 20.2 15.0 

DIETITIAN/NUTRITION SERVICES 

 

37 ICF Macro conducted secondary research of several dozens of WIC sites around the country to develop this list. 
Volume 2: State and Local Agencies (Final Report)

 56 National Survey of WIC Participants II 

Services provided 

Participants served at the whole agency 

(administrative data) 

Total 

(n=503)

% 

<750 

(n=43) 

% 

750–1,999

(n=96) 

% 

2,000–4,499 

(n=120) 

% 

4,500+ 

(n=244) 

% 

Offered by WIC Agency/Clinic itself 86.5 91.4 94.1 92.9 91.2 

Able to provide information 28.6 23.4 22.2 25.5 24.9 

Able to make a referral 16.4 11.5 18.6 18.0 16.0 

None of these -- -- 0.8 0.5 0.3 

PREVENTION AND SCREENINGS (e.g. Vision or Early & Periodic Screening, Immunizations) 

Offered by WIC Agency/Clinic itself*** 87.0 68.1 50.0 43.5 62.7 

Able to provide information** 21.0 41.3 53.3 53.0 41.8 

Able to make a referral* 23.5 30.4 34.9 41.1 32.3 

None of these 2.1 -- 0.7 0.2 0.7 

SEXUALLY TRANSMITTED DISEASES 

Offered by WIC Agency/Clinic itself** 51.6 56.2 43.8 31.0 46.0 

Able to provide information* 39.2 41.2 49.9 53.6 45.7 

Able to make a referral 39.4 32.9 32.0 40.8 36.2 

None of these -- 1.6 3.0 1.7 1.5 

FAMILY PLANNING 

Offered by WIC Agency/Clinic itself** 54.4 54.7 37.4 30.1 44.6 

Able to provide information 41.3 43.7 56.0 55.0 48.7 

Able to make a referral 34.0 36.6 35.3 41.1 36.7 

None of these -- 1.6 1.5 1.6 1.2 

Note 1: Multiple responses were allowed, so totals do not equal 100%. 

Note 2: The difference between categories is statistically significant at the ***p < .0001 level; **p < .001 level; *p < .05 level. 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

Services offered by less than one-third of the local agencies were grouped as shown in Exhibit 4-

26. Children’s health care was offered by almost one-third of the agencies (30.7%), while 

environmental screening, maternal health care, smoking cessation and prenatal health care were 

offered by about one-fourth of the agencies. Dental services and parenting support were provided 

by less than one-fourth of the agencies (20.1% and 17.0%, respectively). Although less than onethird of the agencies offered the services outlined, the majority were able to provide information 

about these services. 

 Non-government agencies were also the least likely to offer environmental health 

screening (12.3%) and smoking cessation services (18.8%). The size of the agency was 

not usually related to the type of services. However, small agencies were the most likely 

to offer maternal health care (30.5%), prenatal health care (29.5%), children’s health care 

(38%), and environmental health screening (35.6%). 
Volume 2: State and Local Agencies (Final Report)

 57 National Survey of WIC Participants II 

Exhibit 4-26: Local WIC Agency: Services Offered by a Minority of Agencies 

Services provided 

Participants served at the whole agency 

(administrative data) 

Total 

(n=503)

% 

<750 

(n=43)

% 

750–1,999 

(n=96) 

% 

2,000–4,499 

(n=120) 

% 

4,500+ 

(n=244) 

% 

CHILDREN’S HEALTH CARE 

Offered by WIC Agency/Clinic itself 38.0 28.1 31.5 25.2 30.7 

Able to provide information 62.9 65.2 63.1 62.2 63.4 

Able to make a referral 45.6 47.5 39.8 44.9 44.6 

None of these -- -- .7 1.3 .5 

ENVIRONMENTAL HEALTH/SCREENING 

Offered by WIC Agency/Clinic itself* 35.6 30.6 17.2 16.6 25.4 

Able to provide information 56.7 54.2 55.4 56.0 55.6 

Able to make a referral 31.5 40.0 33.9 36.7 35.6 

None of these 6.4 5.8 11.9 9.4 8.2 

MATERNAL HEALTH CARE 

Offered by WIC Agency/Clinic itself 30.5 19.5 26.5 23.1 24.8 

Able to provide information 60.2 65.1 64.5 61.7 62.9 

Able to make a referral 46.3 41.4 45.1 48.4 45.2 

None of these -- 1.2 0.7 0.2 0.5 

SMOKING CESSATION 

Offered by WIC Agency/Clinic itself 23.7 23.3 28.4 23.9 24.7 

Able to provide information 63.2 69.5 63.7 66.7 65.9 

Able to make a referral 33.7 43.1 40.1 42.5 39.9 

None of these -- 1.2 2.7 -- 1.0 

PRENATAL HEALTH CARE 

Offered by WIC Agency/Clinic itself 29.5 18.3 24.7 22.0 23.5 

Able to provide information 66.5 75.3 66.8 61.7 67.8 

Able to make a referral 49.4 45.7 43.5 48.2 46.7 

None of these -- -- 0.7 -- 0.2 

DENTAL SERVICES 

Offered by WIC Agency/Clinic itself 17.7 15.2 27.0 21.4 20.1 

Able to provide information 69.7 69.8 60.8 61.7 65.7 

Able to make a referral 44.2 47.2 34.1 39.4 41.5 

None of these -- 0.8 3.6 1.0 1.3 
Volume 2: State and Local Agencies (Final Report)

 58 National Survey of WIC Participants II 

Services provided 

Participants served at the whole agency 

(administrative data) 

Total 

(n=503)

% 

<750 

(n=43)

% 

750–1,999 

(n=96) 

% 

2,000–4,499 

(n=120) 

% 

4,500+ 

(n=244) 

% 

PARENTING SUPPORT 

Offered by WIC Agency/Clinic itself 18.7 14.7 20.4 14.6 17.0 

Able to provide information 57.6 71.0 63.1 67.9 65.0 

Able to make a referral 42.4 38.1 36.5 42.8 40.0 

None of these 8.6 2.2 7.5 0.5 4.6 

Note 1: Multiple responses were allowed, so totals do not equal 100%. 

Note 2: The difference between categories is statistically significant at the ***p < .0001 level; **p < .001 level; *p < .05 level. 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

Services offered the least by local agencies are summarized in Exhibit 4-27. Child care education 

and mental health services were offered by about 10 percent of the local agencies; substance 

abuse services and public assistance were provided by about 6 to 8 percent of the agencies; while 

violence prevention and employment training were offered by less than 4 percent of the agencies. 

The majority of the agencies were able to provide information about these services. The size of 

the agency did not have a clear linear relationship to these services. However, relative to other 

agencies, small agencies were the most likely to offer child care education (17.9%), large ones 

were the most likely to offer mental health services (15.1%), and very large ones were most 

likely to provide substance abuse treatment (13.1%). 

Exhibit 4-27: Local WIC Agency: Least-Often Offered Services 

Services provided 

Participants served at the whole agency 

(administrative data) 

Total 

(n=503)

% 

<750 

(n=43) 

% 

750–1,999

(n=96) 

% 

2,000–4,499 

(n=120) 

% 

4,500+ 

(n=244) 

% 

CHILD CARE EDUCATION 

Offered by WIC Agency/Clinic itself 17.9 8.1 6.6 9.4 10.5 

Able to provide information 64.9 69.2 72.3 69.0 68.8 

Able to make a referral 46.2 46.9 38.0 46.6 44.6 

None of these 6.4 -- 1.6 0.9 2.2 

MENTAL HEALTH SERVICES 

Offered by WIC Agency/Clinic itself 8.4 7.3 15.1 8.8 9.7 

Able to provide information 55.1 63.2 59.7 62.6 60.2 

Able to make a referral 47.3 43.9 38.5 43.7 43.5 

None of these 6.4 5.5 4.8 2.1 4.7 

SUBSTANCE ABUSE COUNSELING/TREATMENT 

Offered by WIC Agency/Clinic itself 7.0 3.5 10.0 13.1 8.2 

Able to provide information 58.2 71.7 67.1 66.6 66.0 

Able to make a referral 48.9 52.3 39.2 45.2 46.7 

None of these 6.4 -- 4.1 0.4 2.7 
Volume 2: State and Local Agencies (Final Report)

 59 National Survey of WIC Participants II 

Services provided 

Participants served at the whole agency 

(administrative data) 

Total 

(n=503)

% 

<750 

(n=43) 

% 

750–1,999

(n=96) 

% 

2,000–4,499 

(n=120) 

% 

4,500+ 

(n=244) 

% 

OTHER PUBLIC ASSISTANCE 

Offered by WIC Agency/Clinic itself 2.9 5.0 8.0 9.0 6.1 

Able to provide information 66.7 72.8 72.7 67.7 70.0 

Able to make a referral 42.6 43.2 41.5 44.6 43.0 

None of these 6.4 0.8 0.7 0.7 2.2 

VIOLENCE PROTECTION/PREVENTION (WOMEN) 

Offered by WIC Agency/Clinic itself -- 1.0 6.5 5.3 3.1 

Able to provide information 68.2 72.3 71.6 70.3 70.6 

Able to make a referral 42.6 49.5 39.3 45.8 44.5 

None of these 6.4 1.6 4.0 1.0 3.2 

VIOLENCE PROTECTION/PREVENTION (CHILDREN) 

Offered by WIC Agency/Clinic itself -- 1.1 4.5 5.3 2.6 

Able to provide information 65.7 71.3 69.4 68.9 68.8 

Able to make a referral 42.6 51.7 41.8 47.7 46.1 

None of these 6.4 1.6 4.0 1.0 3.2 

EMPLOYMENT/LIFE SKILLS TRAINING 

Offered by WIC Agency/Clinic itself -- 1.4 4.1 2.8 2.0 

Able to provide information 57.3 64.5 60.2 65.6 62.0 

Able to make a referral 34.8 34.2 32.3 34.3 33.9 

None of these 17.2 11.6 13.3 11.5 13.4 

Note 1: Multiple responses were allowed, so totals do not equal 100%. 

Note 2: The difference between categories is statistically significant at the ***p < .0001 level; **p < .001 level; *p < .05 level. 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

If a local agency stated that it gave out a referral for any service, a follow-up question was asked 

to clarify what that involved. Specifically, local agencies were asked if they were able to do any 

or all of the following: give out direct referrals for services, hand out the name of an appropriate 

outside organization, or notify an outside organization of a situation. 

Handing participants a direct referral for services was, overall, the most prevalent type of referral 

provided. For all the 19 services listed, a majority of local agencies provided referral services, 

with the exception of violence protection/prevention for women and children (Exhibit 4-28). 

Providing the name of an appropriate organization was also quite common; it usually, but not 

always, lagged behind making direct referrals. Notifying organizations about WIC participants 

was not much practiced, except when it came to violence protection/prevention for women and 

children (23.1% and 34.3% for women and children, respectively) (Exhibit 4-28). 

 The most popular direct referrals were for dietitian/nutrition services, children’s health 

care, maternal health care, prenatal health care, breastfeeding support, and smoking 

cessation—which were done by 65 percent or more of local agencies. 
Volume 2: State and Local Agencies (Final Report)

 60 National Survey of WIC Participants II 

 The top services for which the name of an appropriate organization was provided include 

breastfeeding support, environmental health/screenings, prevention and screenings 

(general), and dietitian/nutrition services and parenting support (referred by over 53% 

of agencies). 

Exhibit 4-28: Types of Referrals for Services Available in Local WIC Agencies 

(Listed by Ability To Hand Out a Referral Sheet) 

Type of service for referral 

Hand out 

referral sheet 

% 

Give out 

organization name 

% 

Notify 

organization 

% 

Other 

% 

Dietitian/nutrition services (n=81) 72.9 54.8 13.0 8.2 

Children's health care (n=224) 69.7 43.6 17.4 6.1 

Maternal health care (n=233) 65.8 43.5 14.3 9.2 

Prenatal health care (n=235) 65.6 45.9 16.0 8.6 

Breastfeeding support (n=84) 65.5 59.4 16.1 12.4 

Smoking cessation (n=211) 65.0 49.5 7.0 7.6 

Dental (n=201) 62.8 40.7 4.2 12.1 

Family planning (n=192) 61.2 50.5 5.9 14.2 

Mental health services (n=220) 60.0 44.7 9.0 9.9 

Prevention and screenings (n=181) 59.8 54.9 11.8 12.0 

Child care/education (n=227) 59.4 51.7 7.9 7.3 

Substance abuse counseling/ 

treatment (n=230) 58.3 51.3 6.5 9.0 

Other public assistance (n=219) 57.0 50.0 5.7 10.0 

Sexually transmitted diseases (n=185) 56.2 46.6 7.2 19.2 

Environmental health/screening (n=183) 54.2 55.1 4.1 12.7 

Parenting support (n=202) 53.1 53.5 7.3 8.8 

Employment/life skills training (n=172) 50.4 48.1 1.5 12.5 

Violence protection/prevention (women) 

(n=226) 49.3 51.4 23.1 8.7 

Violence protection/prevention (children) 45.9 47.4 34.3 8.4 

Note: Multiple responses were allowed, so totals do not equal 100%. 

Source: National Survey of WIC Participants II: State and Local Agencies Report 
Volume 2: State and Local Agencies (Final Report)

 61 National Survey of WIC Participants II 

4.6 Nutrition Education 

Nutrition education and counseling services are the cornerstones of the WIC Program. These 

services are pivotal in educating participants, community partners, and the community about the 

important role good nutrition plays in the development of healthy children and the prevention of 

diet-related conditions, such as diabetes and hypertension. 

Nutrition education is designed to (1) emphasize the connection between nutrition, physical 

activity, and health with special emphasis on the nutritional needs of the WIC participant; and (2) 

assist those who are at nutritional risk to make positive changes in their dietary and physical 

activity habits, with the goal of improving their nutritional status and preventing nutrition-related 

problems through optimal use of the WIC supplemental foods and other nutritious foods. WIC 

regulations specifically say that at least two nutrition education contacts be made available to 

participants during a typical 6 month certification period. 

Key services that the WIC Program provides are nutrition education, breastfeeding promotion 

and support, and preventive measures, such as health care referrals. The WIC Program provides 

these services through various methods that differ between State WIC agencies and, sometimes, 

even between local agencies under the same State WIC agency. 

Local agencies were asked to identify the different forms of nutrition education they offered to 

their WIC participants. The most universal form of nutrition education is one-on-one counseling, 

which is conducted at virtually all local agencies. The majority of the local agencies also offer 

group counseling, whereas only one-third of these agencies offer Internet-based counseling. 

A small percentage offers alternative education dissemination means through educational kiosks, 

interactive displays, posters, and handouts (Exhibit 4-29). 

Exhibit 4-29: Types of Nutrition Education Services Offered 

n=503 Source: National Survey of WIC Participants II: State and Local Agencies Report 

31.5

74.6

99.5

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Internet-based nutrition education 

Group educational sessions

One-on-one counseling

Percentage
Volume 2: State and Local Agencies (Final Report)

 62 National Survey of WIC Participants II 

The type of education provided is similar across agency sizes. The one exception pertains to 

group nutrition sessions: very large agencies that serve more than 4,500 participants per month 

are more likely (86.0%) to offer it than large (81.2%), medium (75.1%), or small 

(57.0%) agencies. 

Whether for one-on-one counseling or group sessions, it is clear that, aside from the 

administrative staff, the responsibility for conducting nutrition education is widely shared among 

key staff. Registered dietitians are the most likely to take part in nutrition education (81.6% of 

agencies), but degreed/licensed nutritionists (62.5%), the WIC director or clinic supervisor 

(52.1%), registered nurses/physician assistants (50.6%), trained nutrition paraprofessional 

(46.8%), and peer counselors (32.4%) also play a role in client education (Exhibit 4-30). 

Exhibit 4-30: Nutrition Counseling Services Offered, by Type of Staff 

10.3

14.0

32.4

46.8

50.6

52.1

62.5

81.6

0% 20% 40% 60% 80% 100%

Other health professionals not listed here

Administrative/clerical/support staff

Peer counselors

Trained nutrition paraprofessional

Registered nurses/physicians assistants

WIC director or clinic supervisor

Degreed/licensed nutritionists

Registered dietitians

Percentage

n=503 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

The type of staff used to provide nutrition education appears to differ across local agencies. 

 WIC directors are less likely to participate in nutrition education in State-affiliated 

agencies (37.9%) than those in local government (57.4%) or non-government (58.9%) 

agency settings. 

 Conversely, registered nurses/physician assistants are more likely to provide nutrition 

education in State-affiliated agencies (67.6%) than in local government (49.4%) and 

non-government agency (33.8%) settings. 

 Non-government and local agencies also rely more on administrative staff (18.8%) than 

their local government and State-affiliated counterparts (11.8% and 13.0%, respectively). 
Volume 2: State and Local Agencies (Final Report)

 63 National Survey of WIC Participants II 

In general, the larger the local agency, the greater each staff’s responsibility in participating in 

nutrition education. As shown in Exhibit 4-31, registered dietitians, nutritionists, clinic directors 

and others spend more time on nutrition education if their agency is larger. The one exception to 

this are registered nurses/physician assistants, whose time allocation seems to decline, perhaps as 

they are supplanted by others on staff. 

Exhibit 4-31: Delegation of Staff Duties, by Size of Local WIC Agency 

39.5

51.3

60.0

58.2

66.1

92.3

80.0 88.1

46.6

58.6

68.7

77.8

32.9

43.4

50.1

62.8

68.8

62.1

42.0

26.7

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

<350 350 to 999 1,000 to 2,999 3,000+

P

e

r

c

e

n

t

a

g

e

o

f

T

i

m

e

P

r

o

v

i

d

i

n

g

N

u

t

r

i

t

i

o

n

E

d

u

c

a

t

i

o

n

Clients Served at Local Agency

WIC director or clinic supervisor Registered dietitians

Degreed/licensed nutritionists Trained nutrition paraprofessional

Registered nurses/physician assistants

n=503 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

Local WIC agencies are required to provide nutrition education at the time of initial certification 

and during follow-up visits. Although not required, participants are strongly encouraged to attend 

these sessions. The majority (56.0%) of agencies provide 10–19 minutes of nutrition education 

during this initial visit (Exhibit 4-32). When the following 3-month period is considered, the 

majority of agencies provide 5–19 minutes of nutrition education (69.1%), with fewer than 

5 percent providing 5 minutes or less (4.8%), and 25.7 percent providing 20 minutes or more 

(Exhibit 4-32). 
Volume 2: State and Local Agencies (Final Report)

 64 National Survey of WIC Participants II 

Exhibit 4-32: Average Duration of Nutrition Education Sessions Provided 

by Local WIC Agencies 

Duration of session 

Average time spent at initial 

certification 

% 

Average time spent during given 

3-month period 

% 

<5 minutes 0.8 4.8 

5–9 minutes 24.1 29.3 

10–19 minutes 56.0 39.8 

20–29 minutes 14.0 14.4 

30–44 minutes 4.1 9.3 

45–59 minutes 0.4 1.2 

60 minutes or more 0.1 0.8 

Total 100.00 -- 

n=503 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

4.7 Agency Procedures at the Main Local Agency Site 

The WIC Program regulations, policies, and guidance that govern how the program is 

administered are numerous and complex. Depending on the issue, an agency policy or procedure 

may be mandated by fixed Federal policy, deferred to the State WIC agency to decide, or 

deferred to the State agency “with a local option,” meaning that the State WIC agency may let 

local agencies determine the procedure. 

To clarify how the various regulations are being carried out at the local agency level, questions 

were asked about the procedures implemented at the main site of the local agency during 

certification, the role of proxies, denials, and controls to prevent duplicate participation. 

Certifications 

Among the majority of local agencies (94.0%), applicants must appear in person for the 

certification process. In agencies where exceptions are allowed, circumstances such as 

“emergency situation,” “note from health care provider,” or “caretaker with note from doctor” 

were cited. The start date for certifications for two-thirds of the agencies begins when the WIC 

application is filled out and all the supporting documentation is turned in (65.5%). For the rest, it 

begins when the applicant first comes into the clinic (22.6%) or when the application is filled out 

(11.9%). In 70.7 percent of the State WIC agencies, local agencies have no discretion about 

certification periods; they remain as set by the State. However, 12.6 percent of the agencies have 

the discretion to give 1-month extensions, and another 16.4 percent have various other areas of 

discretion; for example, “10-day extension for pregnant mothers.” 

The use of temporary certification shows how well prepared applicants are at the time of 

application; it also shows how flexible the local agency is in extending an initial period of 

eligibility. As shown in Exhibit 4-33, 80.0 percent of all agencies grant temporary certification to 

10 percent or fewer of their applicants. 
Volume 2: State and Local Agencies (Final Report)

 65 National Survey of WIC Participants II 

Exhibit 4-33: Percentage of Applicants Given Temporary Certification 

33%

47%

8%

6%

3% 2% 1% 0% 0% 0% 1%

n=503 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

Role of Proxies 

In nearly all local agencies surveyed, proxies are allowed to perform certain functions on behalf 

of WIC participants. The most universal function is picking up food instruments 

(97.7%),followed by attending educational sessions (80.7%). Other less common functions are 

certifying WIC applicants (44.2%) and using food instruments at the store (17.3%). The 17.3 

percent of local agencies which allow proxies to use food instruments at a store is at odds with 

the 92.7% of State agencies that claim they allow this function (see Exhibit 3-21). 

Denied Certification and Recertification 

Applicants for participation in the WIC Program can be denied certification based on— 

 Lack of sufficient identification documentation, 

 Excessive household income, 

 Lack of need based on no identified nutrition risk, 

 Incorrect residence location, or 

 Incorrect category. 
Volume 2: State and Local Agencies (Final Report)

 66 National Survey of WIC Participants II 

As shown in Exhibit 4-34, only a small proportion of applications, for both new applicants and 

recertifications, are denied certification. 

Exhibit 4-34: Average Denial Rates at Local WIC Agencies 

Types of denials: 

Average percentage of 

applicants/participants denied 

WIC 

% 

Percent of local agencies 

% 

(n=503) 

Applicants denied new certification ≤10 96.4 

11–20 2.6 

21–30 0.5 

31–100 0.5 

Total 100.0 

Participants denied recertification ≤10 96.6 

11–20 2.6 

21–100 0.8 

Total 100.0 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

Approximately half of the agencies (52.3%) allow screening and denial by telephone. The types 

of eligibility that may be screened and turned down over the telephone vary, with most agencies 

using that method to determine income eligibility, while almost none allow determinations about 

nutritional eligibility that way (Exhibit 4-35). 

Exhibit 4-35: Eligibility Items That May Be Denied over the Telephone 

Among local agencies where applicants may be denied 

by telephone, percentage allowing denial based on: 

% 

(n=229) 

Income eligibility 97.5 

Category eligibility 68.6 

Residency eligibility 52.5 

Evidence of identification document 8.1 

Nutritional risk eligibility 3.0 

Note: Multiple responses were allowed, so totals do not equal 100%. 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

A total of 84.1 percent of all local agencies retain information about denied applications. 

Typical information retained consists of name, address, and telephone number (kept on file by 

98.3%, 86.8%, and 84.6%, respectively). In terms of data storage, among local agencies that do 

retain denial data, 77.7 percent store denial data on paper and 69.0 percent store these data 

electronically. These percentages include local agencies that use both formats. The breakdown of 

what data are stored and in what format is shown in Exhibit 4-36. 
Volume 2: State and Local Agencies (Final Report)

 67 National Survey of WIC Participants II 

Exhibit 4-36: Format for Denial Data Retention 

Retained information 

Paper storage 

% 

(n=441) 

Electronic storage 

% 

(n=441) 

Name of applicant 81.8 68.6 

Address 74.3 70.2 

Telephone number 72.7 71.3 

WIC applicant category 73.4 72.4 

Reason for denial 80.5 64.9 

Date of application 79.7 69.0 

Date of denial 81.8 66.4 

 

Note: Multiple responses were allowed, so totals do not equal 100%. 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

Controls against Duplicate Participation 

When asked what controls are in place to avoid duplicate participation, local agencies list 

multiple measures, with a computer check based on applicant information being the most 

prevalent (82.5%). Three-fourths state that the applicant must show identification, while an equal 

number state that the applicant must show proof of current residence. The other procedures cited 

almost all deal with some variation of computer-generated matches on such items as name, 

gender, date of birth, Social Security number, and/or WIC status (Exhibit 4-37). 

Exhibit 4-37: Local WIC Agency Controls to Avoid Duplication 

Controls in place 

Total 

% 

(n=503) 

 Computer checks system based on applicant information 82.5 

Applicant must show identification 76.0 

 Applicant must submit proof of current residence 75.6 

 Computer checks system based on Social Security number 24.7 

 Other procedure 16.2 

Note: Multiple responses were allowed, so totals do not equal 100%. 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

Proof of residency is an important component in the process of determining an applicant’s 

eligibility for WIC benefits and in controlling for duplicate participation. Local agencies tend to 

rely heavily on documents provided as receipts from utilities, tax bills, rent, lease, and mortgage 

payments as proof of residency, as shown in Exhibit 4-38. In contrast, few agencies rely on 

income or benefits documents such as pay stubs, pay checks, Social Security Income checks, 

unemployment checks, Medicaid cards, or health insurance cards. 
Volume 2: State and Local Agencies (Final Report)

 68 National Survey of WIC Participants II 

Exhibit 4-38: Types of Residency Proof Accepted 

32.8

11.1

15.3

16.0

32.8

64.0

72.3

91.6

97.6

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Other

Pay stub, pay check, SSI check, unemployment check 

Other mail with name and address on it

Medicaid or health insurance card

Checkbook, bank statement

Written statement from reliable third party

Drivers license, State ID

Rent receipt, mortgage receipt, or lease

Current utility/tax bill with address on it

Percentage

n=503 

Source: National Survey of WIC Participants II: State and Local Agencies Report 

There was little difference in the reliance on these proofs of residence based on the relationship 

between the local agency and the State WIC agency, agency size (in terms of applicants served 

or number of staff), or the ratio of participants served to the local agency staff. 
APPENDIX A: 

DATA COLLECTION INSTRUMENT FOR 

STATE WIC AGENCIES
 A-1 National Survey of WIC Participants II 

State WIC Agency Survey 

Thank you for responding to the FNS’ second National Survey of WIC Participants, 

administered by ICF Macro. Please refer to the accompanying cover letter for full details of the 

research effort. If you have any questions, please contact Walter Rives at 1-888-285-7976 or 

email WICSurvey@mmail.macrointernational.com. 

This survey—along with surveys of local agencies and participants—is designed to provide FNS 

with additional information on policies and program operations, beyond those available from 

existing program sources. For your convenience, the survey is organized by topic. 

Please return the survey in the postage-paid envelope provided. 

Public reporting burden for this collection of information is estimated to average 66 minutes per response, 

including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data 

needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a 

person is not required to respond to, a collection of information unless it displays a currently valid OMB control 

number. Send comments regarding this burden estimate or any other aspect of this collection of information, 

including suggestions for reducing this burden, to: U.S. Department of Agriculture, Food and Nutrition Services, 

Office of Research and Analysis, Room 1014, Alexandria, VA 22302 ATTN: PRA (0584-0484). 

STATE: __________________________ 
OMB Number: 0584-0484 

 Expiration Date: 06/30/2012 

 A-2 National Survey of WIC Participants II 

1. Which programs establish adjunctive or other automatic State eligibility for a WIC applicant 

in your State? (CHECK OFF ALL PROGRAMS THAT ESTABLISH ELIGIBILITY IN THE LEFT 

HAND COLUMN. PROGRAMS THAT ARE REQUIRED BY § 246.7 WIC PROGRAM REGULATIONS 

ARE ALREADY CHECKED FOR YOU.) 

 1A. For each item checked in Question 1, please 

indicate what, if any proofs, the State requires local 

agencies to collect. (CHECK ALL THAT APPLY) 

(CHECK ALL THAT APPLY)

No specific 

requirements 

are set 

Proof of 

certification 

(e.g. card) 

Award 

letter 

Active 

program 

voucher 

Other: 

PLEASE 

SPECIFY 

 Food Stamps 

 Medicaid 

 TANF 

 Children’s Medicaid 

 Supplemental Security Income 

(SSI) 

 Free and Reduced-Meal School 

Lunch/Breakfast Program 

 

 Food Distribution Program on 

Indian Reservations (FDPIR) 

 

 Low-Income Energy Assistance 

 Other: PLEASE SPECIFY 

___________________________ 

 Other: PLEASE SPECIFY 

___________________________ 

 

2. Do any of the programs checked above, that establish adjunctive or other automatic State 

eligibility, allow people to participate whose income may exceed the normal “185% of the 

federal poverty income” standard that is used to establish income eligibility? 

 Yes 

 No (SKIP TO QUESTION 3)

2A. Which ones? (CHECK ALL THAT APPLY) 

 Food Stamps  Supplemental Security Income (SSI) 

 Medicaid  Free and Reduced-Meal School Lunch/Breakfast Program 

 TANF  Food Distribution Program on Indian Reservations (FDPIR)

 Children’s Medicaid  Low-Income Energy Assistance 

 Other: PLEASE SPECIFY _____________________________ 







STATE ELIGIBILITY GUIDANCE TO LOCAL WIC AGENCIES 
OMB Number: 0584-0484 

 Expiration Date: 06/30/2012 

 A-3 National Survey of WIC Participants II 

3. When adjunctive/automatic eligibility is NOT established, what sources of income does 

your State require local agencies to count when determining the income eligibility of an 

applicant? (CHECK ALL THAT APPLY)

 Wages, salary, fees  Social Security  Energy assistance

 Tips and bonuses  Private pension  Rental assistance

 Self employment  Disability pension  Net rental income

 Unemployment 

compensation 

 Medical assistance 

(any)

 Dividends or interest from 

savings 

 Workers 

compensation 

 SSI – Fed 

government 

 Regular contributions 

from persons not in 

household

 Child support  SSI—State issued  Income from trusts

 Commissions  Income from estates  Welfare 

 Public assistance  Net royalties  Other: SPECIFY 

 Alimony  Other cash income __________________ 

 

4. In determining the income of an applicant where unemployment is not an issue, does the 

State instruct local agencies to use income from the last year, to use current income, or is it 

left up to the judgment of the local agencies? 

 Income from last year used 

 Current income used 

 Left to local agencies to decide 

 Other: PLEASE SPECIFY ________________________________ 

5. What types of proof are acceptable in your State to verify the sources of income for WIC 

applicants? (CHECK ALL THAT APPLY) 

 Most recent tax return 

 Check or pay stubs 

 Signed statement by employer 

 Statement of benefits by public agency or court 

 Statement of benefits for child support and alimony 

 Leave and Earnings Statement (LES) for military pay 

 Unemployment letter or notice letter signed by official State/local agency 

attesting to client’s low income 

 Written statement from reliable third party 

 Statement from bank or other financial institution savings (e.g. direct deposit) 

 Accounting records (for self-employed individuals) 

 Scholarship letter (e.g. for students) 

 Other: PLEASE SPECIFY _____________________ 

5A. How does the State determine “most recent” income? (Be as specific as possible, or attach 

supporting documentation) 
OMB Number: 0584-0484 

 Expiration Date: 06/30/2012 

 A-4 National Survey of WIC Participants II 

____________________________________________ 

____________________________________________ 

____________________________________________ 

____________________________________________ 

6. Does the State use or grant discretion to local agencies regarding income determination? 

 No 

 Yes, discretion is given 

6A. State or local income guidelines used for WIC are adopted from which of the following 

services? 

 Free and Reduced Health Care (e.g. Maternal Health Care, Pediatric Health Care) 

_____% Federal Poverty Level 

 Free and Reduced Priced School Meals 

_____% Federal Poverty Level 

 Other (Specify: Provide supporting policy statements)______________________ 

_________________________________________________________________ 

_____% Federal Poverty Level 

7. For applicants not likely to have any proof of income--e.g., homeless, or migrant farm 

worker who works for cash, does the State allow self-declaration of income with applicants 

signed statement of why documentation cannot be provided? 

 Yes 

 No 

8. When an infant turns 1 year, does the 6 months certification period remain valid, or does the 

infant become categorically ineligible and need to again be certified based on criteria used 

for children? 

 The 6 month certification period remains valid 

 The infant becomes categorically ineligible and needs to again be certified based 

on criteria used for children 

 Neither. There is no State policy. Discretion is given to local agencies 

9. Does your State use a data month or calendar month for issuance cycles? 

 Calendar month(benefits continue until the end of the month) 

 Data month (benefits continue until next 30-day period of eligibility ends) 

10. For temporary low-income persons (e.g. strikers), does the State allow the full certification 

period or shorten the certification period based on anticipated income increase? 

 Allows full certification period 

 Shortens certification period based on anticipated income increase 
OMB Number: 0584-0484 

 Expiration Date: 06/30/2012 

 A-5 National Survey of WIC Participants II 

11. What other discretion, if any, does the State use or grant to local agencies regarding 

certification periods? 

 No additional discretion is given 

 Other discretion is given: (Specify) 

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________ 

12. What additional guidelines, if any, are given by the State to local agencies to help them 

determine the WIC economic/family unit above and beyond the national WIC program 

definition which defines it as “a group of related or nonrelated individuals who are living 

together?” 

 No additional discretion is given 

 The following discretion is given: (PROVIDE SUPPORTING POLICY 

STATEMENTS AS APPROPRIATE.) 

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________ 

__________________________________________________________________ 

 
OMB Number: 0584-0484 

 Expiration Date: 06/30/2012 

 A-6 National Survey of WIC Participants II 

13. In determining household income, does the State exclude any of the following military 

housing allowances? (CHECK ALL THAT APPLY) 

 Basic Allowance for Housing (BAH) for off-base housing and 

privatization housing in the U.S. 

 Family Separation Housing (FSH) provided to military personnel for 

overseas housing. 

 Overseas Housing Allowance (OHA) provided to military personnel 

living overseas. 

 Overseas Continental U.S. (OCONUS) cost of living allowance 

(COLA) provided to active duty uniformed service members in Hawaii, 

Alaska, and Guam. 

14. Regarding Children in Temporary Care of Friends/Relatives, does the State: (CHOOSE 

ONE) 

 Count absent parents and children as one unit. 

 Count the children as a separate unit in which case they should have 

separate income, e.g., child allotment. 

 Count the children as part of the economic unit of the person with 

whom they are residing. 

15. What types of identification are acceptable in your State to verify the residency of a WIC 

applicant? (CHECK ALL THAT APPLY)

 Driver’s license 

 Current utility/tax bill with address on it 

 Written statement from reliable third party 

 Checkbook 

 Signed statement by applicant that he/she is victim of loss or disaster, or is 

homeless, a migrant person, or military personnel. 

 Rent receipt, mortgage receipt or lease 

 Other: PLEASE SPECIFY ____________________________________ 

 Other: PLEASE SPECIFY ____________________________________ 

 Other: PLEASE SPECIFY ____________________________________ 

 Other: PLEASE SPECIFY ____________________________________ 

 Other: PLEASE SPECIFY ____________________________________ 

16. Does the State require applicants to reside within the State to be eligible for WIC? 

 Yes 

 No 
OMB Number: 0584-0484 

 Expiration Date: 06/30/2012 

 A-7 National Survey of WIC Participants II 

17. Do local agencies (i.e. the umbrella agencies above the local clinics) have non-overlapping 

jurisdictions with one another? (For example, county boundaries) 

 Yes 

 No 

18. Check the statement that best describes your residency requirements for WIC participants: 

 WIC participants must reside within the boundary of the WIC local clinic where 

she/he resides. 

 WIC participants must reside within the boundary of the WIC local agency 

(overseeing the clinic) where she/he resides. 

 WIC participants only need to show that they live somewhere within the State. 

 The decision about whether a WIC participants must reside within the local 

agency/clinic boundary or can simply reside in the State is left to local agencies 

and/or clinics to decide 

 Other. PLEASE SPECIFY____________________________________________ 

19. How often does the State regularly review the records of WIC participants to identify 

duplicate certifications across local agencies? 

 Process is automated and constant. State’s WIC system looks for 

duplicate records at time of certification and at subsequent 

certifications 

 10-12 times a year (e.g. monthly) 

 7-9 times a year 

 4-6 times a year (e.g. quarterly) 

 2-3 times a year (e.g. semiannually) 

 Once a year or less 

 Never 

 Don’t know 

20. At the current time, does your State use FNS’s WIC Nutrition Risk Criteria to ascertain 

nutritional eligibility or does the State bundle the codes into its own unique groupings? 

 Use FNS criteria 

 Bundle codes 

 Other. PLEASE EXPLAIN___________________________________________ 
OMB Number: 0584-0484 

 Expiration Date: 06/30/2012 

 A-8 National Survey of WIC Participants II 

21. In the following table, please list by code number (for example, 331—pregnancy at a 

young age) the seven most prevalent nutritional risk code indicators in your State, by 

category. NOTE: IF YOUR STATE HAS BUNDLED CODES, LIST ALL CODES IN 

BUNDLE IN A CELL OR, IF YOU DO NOT USE FNS CODE NUMBERING, REFER 

TO BUNDLE IN A CELL AND ATTACH A CROSSWALK TABLE OR KEY). 

Pregnant Breastfeeding Postpartum Infants Children 

1st (Most 

prevalent) 

 

2nd 

3rd 

4th 

5th 

6th 

7th (Least 

prevalent of top 

risk codes) 

 

 Check if above are new VENA FNS codes 

 Check if you are using FNS Codes but are NOT using the new VENA codes for 

dietary risks 

 Check if above are you own codes, NOT FNS codes (Please include crosswalk 

table or key) 

22. When does your State plan to have the VENA (Value Enhanced Nutrition Assessment) 

protocols fully implemented at the local level? 

 It is already implemented 

 By end of 2009 

 By end of 2010 

 Later than 2010 
OMB Number: 0584-0484 

 Expiration Date: 06/30/2012 

 A-9 National Survey of WIC Participants II 

DENIALS 

23. Does State policy require that local WIC agencies keep information on denied applicants? 

 Yes 

 No (SKIP TO QUESTION 25)

24. What information on Denied Applicants is required to be retained by the State? 

(CHECK ALL THAT APPLY) 

 Name of applicant 

 Address 

 Phone number 

 WIC applicant category 

 Reason for denial 

 Date of application 

 Date of denial 

24A. How is the Denied Applicant information retained? 

 No specific retention requirements 

 Paper copy only 

 Electronic copy only 

 Both paper and electronic

25. Is it State policy to have local agencies send an official letter of denial to applicants who 

are denied eligibility for WIC? 

 Yes 

 No 

FOOD PACKAGES & NUTRITION SERVICES 

26. What, if any, assistance does the State provide to local agencies for the specific purpose of 

promoting breastfeeding? 

 Funding for breastfeeding coordinators or peer counselors 

 Training for personnel to support breastfeeding 

 Printed breastfeeding materials (hand-outs, posters, etc.) 

 Free breast pumps for distribution 

 Other: PLEASE DESCRIBE BRIEFLY ____________________________ 

_____________________________________________________________ 

_____________________________________________________________ 

 None 

27. Which of the following actions are designated proxies allowed to do in your State on behalf 

of the WIC participants they represent? 
OMB Number: 0584-0484 

 Expiration Date: 06/30/2012 

 A-10 National Survey of WIC Participants II 

 Get certification for the WIC applicant 

 Pick up food instruments 

 Attend educational sessions 

 Spend food instruments 

 Not Applicable. State does not allow proxies 

 Other: PLEASE SPECIFY ______________________________________ 

28. How frequently are food instruments distributed throughout the State via the following 

distribution methods? (PLEASE CHECK ONE ANSWER FOR EACH) 

Most of 

the time 

Some of 

the time Occasionally Not at all 

a. In person at a local WIC site 

b. EBT (electronic benefit cards) 

c. By mail 

d. Other: PLEASE SPECIFY 

_____________________ 

 
OMB Number: 0584-0484 

 Expiration Date: 06/30/2012 

 A-11 National Survey of WIC Participants II 

RECORD-KEEPING & SYSTEMS 

29. Please indicate for how long, if at all, the following WIC Participant data is kept at the 

State level. (CHECK ALL THAT APPLY. EACH ROW SHOULD HAVE AT LEAST ONE CHECK.)

Possible data stored: 



State does 

not retain 

this 

information 

State stores 

only most 

current 

information 

(i.e. no record 

of previous 

changes) 

State stores current and previous 

information (including changes) for... 

Up to 3 

months 

4-8 

months 

9-12 months Over a 

Year 

Client name 

Clinic attended 

Family identification 

or affiliation 

 

Category of eligibility 

Client address 

Client telephone 

Second client 

telephone 

 

Food package issued 

Value of food package 

redeemed 

 

Program through 

which adjunctively/ 

automatically income 

eligible 

 

Proofs of income (if 

not adjunctively/automatically eligible) 

 

Primary language 
OMB Number: 0584-0484 

 Expiration Date: 06/30/2012 

 A-12 National Survey of WIC Participants II 

30. What proofs of eligibility are local WIC agencies required to keep in their files? 

Local agency must keep... (CHECK ALL THAT APPLY)

For what types 

of 

documents...? 

 

Original 

document/s 

Copy of 

original 

document/s 

Identifying 

number of 

original 

document 

A written statement or 

notation (such as a 

check mark) that an 

acceptable document 

was shown to the 

(re)certification staff. 

None of 

these 

items 

Documents 

proving adjunctive/ automatic 

eligibility 

 

Proofs of income 

(wages, fees and 

tips, etc.)

 

Nutritional 

eligibility 

paperwork 

 

Categorical 

eligibility 

paperwork 

 

Proof of 

residency 

 

31. Are proofs of eligibility stored at the State level? (CHECK ONE FOR EACH) 

YES NO 

   Documents proving adjunctive/automatic eligibility 

   Proofs of income 

  Nutritional eligibility paperwork 

   Categorical eligibility paperwork 

   Proof of residency 

32. What is the longest that local agencies may wait before sending applicant data to the State 

WIC agency about new WIC certificants and recertificants? 

 30 days or less 

 31-60 days 

 61-90 days 

 Other: PLEASE SPECIFY ______________________________________ 
OMB Number: 0584-0484 

 Expiration Date: 06/30/2012 

 A-13 National Survey of WIC Participants II 

33. With regard to the State’s database of WIC participants... 

1. What does State use to 

store participant data? 

 Mainframe server 

 QuickWIC (web-based) 

 Other: SPECIFY 

_______________ 

2. What databases are used? 

 Access (MDB) 

 Excel (XLS) 

 Oracle 

 SAS 

 SPSS (SPS) 

 XML 

 Other: SPECIFY________________

34. Please indicate the maximum number of days that... 

a. participants are given to use their 

food instruments after start date? 

________ days 

b. vendors can take to deposit redeemed 

food instruments in their bank? ________ days 

c. vendors’ banks can take to turn the 

food instruments over to the State 

WIC agency’s bank? ________ days 

 Check here if question 

does not apply because 

vendors must turn in their 

coupons to the State WIC 

agency’s bank

GENERAL CHARACTERISTICS 

35. For the State as a whole, how many WIC clients are: (PLEASE GIVE YOUR BEST ESTIMATE 

OF ACTUAL NUMBERS)

a. migrant farmworkers ___________ b. homeless individuals ___________ 

36. What is the number of WIC local agencies in the State? 

__________ LOCAL AGENCIES 

37. What is the number of WIC clinics or sites, including satellite sites in the State? (IF 

MOBILE UNIT IS ATTACHED TO A SINGLE CLINIC OR SITE, DO NOT CONSIDER IT A SITE. IF 

MOBILE UNIT SERVES MUTLIPLE SITES, CONSIDER IT A SEPARATE SITE.) 

___________ LOCAL CLINICS/SITES 

YOUR TIME COMPLETING THE SURVEY IS GREATLY APPRECIATED. 

THANK YOU! PLEASE RETURN PROMPTLY IN ENVELOPE PROVIDED. 
APPENDIX B: 

DATA COLLECTION INSTRUMENT FOR 

LOCAL WIC AGENCIES
 B-1 National Survey of WIC Participants II 

Public reporting burden for this collection of information is estimated to average 40 minutes per response, 

including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data 

needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a 

person is not required to respond to, a collection of information unless it displays a currently valid OMB control 

number. Send comments regarding this burden estimate or any other aspect of this collection of information, 

including suggestions for reducing this burden, to: U.S. Department of Agriculture, Food and Nutrition Services, 

Office of Research and Analysis, Room 1014, Alexandria, VA 22302. 

OMB Control No.: 0584-0484. Expiration Date 6/30/2012 
 B-2 National Survey of WIC Participants II 

Local WIC Agency Survey 

Thank you for participating in the FNS’ second National Survey of WIC Participants, 

administered by ICF Macro. Please refer to the accompanying cover letter for full details of the 

research effort. If you have any questions, please contact Walter Rives at 1-888-285-7976 or 

email him at WICSurvey@mmail.macrointernational.com. 

This survey—along with surveys at the State and participant levels—is designed to provide FNS 

with additional information on policies and program operations, above and beyond that which is 

available from existing program sources. For your convenience, the survey is organized by topic. 

There is a space for additional comments at the very end. 

SCREENER 

S1. Does this local agency conduct certifications and recertifications of WIC applicants, or 

does it serve as a purely administrative office, overseeing these functions at the clinic 

level? 

 Agency to which this survey was addressed does certifications and 

recertifications 

 CONTINUE TO SURVEY 

 Agency serves as a purely administrative office 

 Not sure PLEASE CONTACT WALTER RIVES AT 

ICF MACRO TO CLARIFY IF YOU SHOULD FILL OUT 

THIS SURVEY. 

Phone: 1-888-285-7976 

Email: 

WICSurvey@mmail.macrointernational.com 
 OMB Number: 0584-0484 

WEB SURVEY Expiration Date: 6/30/2012 

 B-3 National Survey of WIC Participants II 

 Until directed otherwise, please answer all the questions as they apply to 

just this location of your local agency or clinic.

CHARACTERISTICS OF LOCAL WIC AGENCY 

1. Which description most closely fits the structure in which your local agency or clinic is 

located? (CHECK ONE)

 Health department or medical clinic 

 Social services office or agency 

 Full service hospital 

 School 

 Site of non-profit organization 

 Site of religious group 

 Other: PLEASE SPECIFY ____________________________ 

2. How many rooms does the WIC program use, excluding such things as hallways, bathrooms, 

kitchen, and storage closets? Please select the total for each type of room. [PLEASE GIVE THE 

NUMBER.] 

 Large waiting rooms/reception areas (greater than 15x15 feet) 

 Small waiting rooms/reception areas (15x15 feet or smaller) 

 Rooms, offices or cubicles where clients are seen 

 Large training/conference/multipurpose rooms 

 Small training/conference/multipurpose rooms 

 Administrative offices (no clients seen) 

 Administrative cubicles (no clients seen) 

 Other: PLEASE SPECIFY ______________________________ 

3. How many days a week, on average is the 

agency open to clients/applicants? _____ DAYS

4. How many hours per week, on average, is 

the WIC agency open? _____ HOURS 

5. How many of the hours are “extended 

hours,” meaning they take place before 

9 AM and after 5 PM? 

_____ HOURS 

6. Approximately how many clients are served 

at the agency per month? __________ CLIENTS/MONTH 

7. Of these, approximately what percentage are 

certifications and recertifications? __________ % 
 OMB Number: 0584-0484 

WEB SURVEY Expiration Date: 6/30/2012 

 B-4 National Survey of WIC Participants II 

8. What types of public transportation are 

within a 10 minute walk (1/2 mile) of the 

agency? (CHECK ALL THAT APPLY)

 Bus 

 Light rail/subway/commuter train 

 Other 

 None 

9. What is the most-frequent means of 

transport used by WIC applicants and 

participants to get to your agency? 

 Private car 

 Taxi 

 Bus 

 Light rail/subway/commuter train 

 On foot 

 Other 

10. What is the second most-used means of 

transport used by WIC applicants and 

participants to get to your agency? 

 Private car 

 Taxi 

 Bus 

 Light rail/subway/commuter train 

 On foot 

 Other 

11. How would you rate the physical security of 

your local agency’s location? 

 Very safe (No incidents) 

 Safe (Occasional minor incidents) 

 Unsafe (Occasional major incidents or 

frequent minor incidents) 

 Very unsafe (Frequent major incidents) 

12. Does the agency have on-site the necessary technology, equipment, supplies, etc., to do the 

following tasks? 

a) Enter/access client certification information via a 

computer? 

i. Is this computer networked to other 

computers in the office (i.e., a shared drive)? 

ii. Is this computer networked to other 

agencies, clinics, or the State WIC office? 

 Yes  No  Don’t Know 

 Yes  No  Don’t Know 

 Yes  No  Don’t Know 

b) Have internet access?  Yes  No  Don’t Know 

c) Perform hematological tests?  Yes  No  Don’t Know 

d) Take anthropometric measurements for 

weight, BMI (body mass), and height? 

 Yes  No  Don’t Know 
 OMB Number: 0584-0484 

WEB SURVEY Expiration Date: 6/30/2012 

 B-5 National Survey of WIC Participants II 

13. For each of the following services, please indicate if your local agency is able to offer the 

service, provide information and/or make referrals in the following areas. “Ability to make 

a referral” means that your local agency’s involvement is required to obtain a particular 

service whereas “ability to provide information” means that you have only given client the 

information about the problem and possibly places to go for help. (CHECK ALL THAT APPLY)

Offered by

WIC 

Agency/ 

Clinic

Able to 

provide 

information 

Ability 

to make a 

referral Neither

Maternal health care    

Prenatal health care    

Children’s health care    

Prevention (e.g., immunizations) and Screenings 

(e.g., vision or Early & Periodic Screening)    

Breastfeeding support    

Dietitian/nutrition services    

Mental health services    

STD (sexually transmitted diseases)    

Dental    

Family planning    

Child care/education (e.g., Healthy Start, Head Start)    

Parenting support    

Employment/life skills training    

Other public assistance    

Environmental health/screening    

Substance abuse counseling/treatment    

Smoking cessation    

Violence Protection/Prevention (women)    

Violence Protection/Prevention (children)    

OTHER: SPECIFY______________________    
 OMB Number: 0584-0484 

WEB SURVEY Expiration Date: 6/30/2012 

 B-6 National Survey of WIC Participants II 

FOR ALL ITEMS WHERE REFERRALS ARE CHECKED IN Q13, ASK: 

13A. In Q13, you indicated that you give referrals for certain services. For just those services 

where referrals are given, please mark which type of referral is given

a. WIC client gets referral sheet to take to other organization 

b. Organization is given name of WIC client to contact (with client’s knowledge) 

c. Organization is notified of WIC client situation (without client’s knowledge—

e.g., protective services—as permitted by law) 

d. Other 

For all services in Q13 where referrals are given 

out, check all that apply. 

(If no referrals given, leave blank.)

a.

Referral 

sheet 

b. 

Org’l 

name is 

given out 

c. 

Org. is 

notified 

d.

Other 

Maternal health care 

Prenatal health care 

Children’s health care 

Prevention (e.g., immunizations) and Screenings 

(e.g., vision or Early & Periodic Screening) 

Breastfeeding support 

Dietitian/nutrition services 

Mental health services 

STD (sexually transmitted diseases) 

Dental 

Family planning 

Child care/education (e.g., Healthy Start, Head Start) 

Parenting support 

Employment/life skills training 

Other public assistance 

Environmental health/screening 

Substance abuse counseling/treatment 

Smoking cessation 

Violence Protection/Prevention (women) 

Violence Protection/Prevention (children) 

OTHER: 
 OMB Number: 0584-0484 

WEB SURVEY Expiration Date: 6/30/2012 

 B-7 National Survey of WIC Participants II 

AGENCY PROCEDURES 

14. What types of identification does the agency use to verify the residency of a WIC 

applicant? (CHECK ALL THAT APPLY)

 Drivers license 

 Current utility/tax bill with address on it 

 Written statement from reliable third party 

 Checkbook 

 Rent receipt, mortgage receipt, or lease 

 Other: PLEASE SPECIFY _____________________________________ 

 Other: PLEASE SPECIFY _____________________________________ 

 Other: PLEASE SPECIFY _____________________________________ 

 Other: PLEASE SPECIFY _____________________________________ 

15. Does the agency keep a copy of documents proving adjunctive or automatic eligibility for 

applicants? 

 Yes, physical copy 

 Yes, electronic copy (scanned document) 

 No 

16. When does the start-date for a certification occur? (CHECK ONE BEST ANSWER)

 When the WIC applicant first comes into the clinic 

 When the WIC application is filled out 

 When the WIC application is filled out and all supporting information provided 

17. What discretion, if any, does the state use or grant to local agencies regarding certification 

periods? 

 No additional discretion is given 

 The following discretion is given: (PROVIDE SUPPORTING POLICY STATEMENTS 

AS APPROPRIATE ) 

 ___________________________________________________________ 

 ___________________________________________________________ 

 ___________________________________________________________ 

18. Do certifications have to take place in person? 

 Yes [SKIP TO Q20] 

 No 
 OMB Number: 0584-0484 

WEB SURVEY Expiration Date: 6/30/2012 

 B-8 National Survey of WIC Participants II 

19. If no, by what other means can WIC applicants be certified? (CHECK ALL THAT APPLY)

 Phone 

 Mail 

 Fax 

 Other: PLEASE SPECIFY ___________________ 

20. Approximately what percentage of WIC applicants are given temporary certification, that 

is, 30 days of food instruments while the validity of their application for WIC certification is 

being established? 

[CIRCLE ONE ANSWER IN BOX WITH...] 

21. Which of the following actions are designated proxies allowed to do on behalf of the WIC 

participants they represent? 

 Get certification for the WIC applicant 

 Pick up food instruments 

 Attend educational sessions 

 Other: PLEASE SPECIFY ______________________________________ 

 Not Applicable. State does not allow proxies 

22. What controls are in place to ensure that a WIC applicant is not already participating in 

WIC at a different location? (CHECK ALL THAT APPLY) 

 Applicant must show identification 

 Applicant must submit proof of current residence 

 Computer checks system based on applicant name 

 Computer checks system based on Social Security number 

 Other procedure: PLEASE DESCRIBE _______________________ 

 0% 

 1 – 10% 

 11 – 20% 

 21 – 30% 

 31 – 40% 

 41 – 50% 

 51 – 60% 

 61 – 70% 

 71 – 80% 

 81 – 90% 

 91 – 100% 

20a. How confident are you in the range 

entered here? 

 Very confident 

 Somewhat confident 

 Not very confident 

(i.e., a lot of guesswork involved)
 OMB Number: 0584-0484 

WEB SURVEY Expiration Date: 6/30/2012 

 B-9 National Survey of WIC Participants II 

23. Of applicants new to WIC, what percentage is denied certification? 

[CIRCLE ONE ANSWER IN BOX WITH...] 

24. Of WIC participants seeking recertification, what percentage is denied certification? 

[CIRCLE ONE ANSWER IN BOX WITH...] 

25. Please specify the percentage of denials that are attributable to the following eligibility 

problems. It is possible the percentages may sum to more than 100% as applicants may be 

denied that for more than one reason. 

Insufficient identification _____ % 

Income ineligibility _____ % 

Nutritional ineligibility _____ % 

Residency ineligibility _____ % 

Category ineligibility (i.e., not 

pregnant, child over 5 years, etc.) _____ % 

Other: PLEASE SPECIFY 

_______________________ _____ % 

23a. How confident are you in the range 

entered here? 

 Very confident 

 Somewhat confident 

 Not very confident 

(i.e., a lot of guesswork involved)

25a. How confident are you in the 

percentages entered here? 

 Very confident 

 Somewhat confident 

 Not very confident 

(i.e., a lot of guesswork involved) 

24a. How confident are you in the range 

entered here? 

 Very confident 

 Somewhat confident 

 Not very confident 

(i.e., a lot of guesswork involved) 

≤10% 

 11 – 20% 

 21 – 30% 

 31 – 40% 

 41 – 50% 

 51 – 60% 

 61 – 70% 

 71 – 80% 

 81 – 90% 

 91 – 100% 

≤10% 

 11 – 20% 

 21 – 30% 

 31 – 40% 

 41 – 50% 

 51 – 60% 

 61 – 70% 

 71 – 80% 

 81 – 90% 

 91 – 100% 
 OMB Number: 0584-0484 

WEB SURVEY Expiration Date: 6/30/2012 

 B-10 National Survey of WIC Participants II 

26. Does the agency keep information on denied applicants? 

 Yes 

 No [SKIP TO Q28] 

27. What information on Denied Applicants do you retain and how is it retained? (ANSWER b. 

AND c. ONLY IF a. IS CHECKED.) 

a. Information Retained (CHECK 

ALL THAT APPLY) 

b. How Retained 

(CHECK ONE) 

c. Where Retained 

(CHECK ALL THAT APPLY) 

 Name of applicant  Paper copy only 

 Electronic copy only 

 Both paper and electronic 

 WIC State Agency 

 Your Local Agency 

 Sites/Clinics 

 Address  Paper copy only 

 Electronic copy only 

 Both paper and electronic 

 WIC State Agency 

 Your Local Agency 

 Sites/Clinics 

 Phone number  Paper copy only 

 Electronic copy only 

 Both paper and electronic 

 WIC State Agency 

 Your Local Agency 

 Sites/Clinics 

 WIC applicant category  Paper copy only 

 Electronic copy only 

 Both paper and electronic 

 WIC State Agency 

 Your Local Agency 

 Sites/Clinics 

 Reason for denial  Paper copy only 

 Electronic copy only 

 Both paper and electronic 

 WIC State Agency 

 Your Local Agency 

 Sites/Clinics 

 Date of application  Paper copy only 

 Electronic copy only 

 Both paper and electronic 

 WIC State Agency 

 Your Local Agency 

 Sites/Clinics 

 Date of denial  Paper copy only 

 Electronic copy only 

 Both paper and electronic 

 WIC State Agency 

 Your Local Agency 

 Sites/Clinics 

28. Does the agency send an official letter of denial to applicants who are denied eligibility for 

WIC? 

 Yes 

 No 
 OMB Number: 0584-0484 

WEB SURVEY Expiration Date: 6/30/2012 

 B-11 National Survey of WIC Participants II 

29. Can an applicant be screened and denied eligibility by telephone? 

 Yes 

 No [SKIP TO Q31] 

30. For which reasons can an applicant be screened and denied eligibility by telephone? 

(CHECK ALL THAT APPLY)

 Insufficient identification 

 Income eligibility 

 Nutritional eligibility 

 Residency eligibility 

 Category eligibility 

 Other: PLEASE SPECIFY: ________________________ 

NUTRITION SERVICES 

31. What nutrition services are offered by your local agency? (CHECK ALL THAT APPLY)

 One-on-one counseling 

 Group educational sessions 

 Internet-based nutrition education for clients to use 

 Other: PLEASE SPECIFY: ________________________ 

32. Who provides these nutrition services? (CHECK ALL THAT APPLY)

 WIC Director or Clinic Supervisor 

 Registered Dietitians 

 Degreed/Licensed Nutritionists 

 Trained Nutrition Paraprofessional 

 Registered Nurses/Physicians Assistants 

 Physicians 

 Social Workers/ Psychologists/ Therapists 

 Other Health Professionals not listed here 

 Other Non-Health Professionals not listed here 

 Administrative/clerical/support staff 

 Peer Counselors 

33. On average, how much time is spent giving nutrition education to an adult client during the 

certification process? 

[CIRCLE ONE:] None 

 <5 minutes 

 5 – <10 minutes 

 10 – <20 minutes 

 20 – <30 minutes 

 30 – <45 minutes 

 45 – <60 minutes 

 60 minutes or more
 OMB Number: 0584-0484 

WEB SURVEY Expiration Date: 6/30/2012 

 B-12 National Survey of WIC Participants II 

34. In a given 3-month period, on average, how much time is spent giving nutrition education 

to an adult client during follow-up visits (excluding the initial certification)? 

[CIRCLE ONE:] 

35. What percentage of infants are certified off-site (e.g., in the hospital)? 

 _______% 

36. What types of outreach does your local agency do in, or with, hospitals to help bring 

qualified infants into the WIC program? (CHECK ALL THAT APPLY)

 Agency staff visit currently-certified and prospective WIC mothers in the 

hospital 

 Agency provides general information and/or specific forms to the hospital for 

distribution 

 Agency staff provide pregnant mothers with WIC forms (for their infants) for 

hospital physicians to fill out 

 Agency joins with other social service agencies to provide a place at the hospital 

where prospective clients can shop services, all in one place 

 Other: PLEASE SPECIFY____________________________ 

From this point forward, please answer the remaining 16 questions as they apply to the 

WIC local agency in its entirety, including all clinics, satellites and mobile units. 

LOCAL AGENCY ORGANIZATION 

37. How would you describe the relationship of your WIC local agency to the WIC State 

agency? Your local agency is... (CHECK ONE)

 part of State agency 

 a local government entity administering the WIC program 

 a non-profit organization that has been contracted to run the WIC program 

 not a local agency, but rather a clinic under a local agency 

 Other: PLEASE SPECIFY________________________ 

 None 

 <10 minutes 

 10 – <20 minutes 

 20 – <30 minutes 

 30 – <45 minutes 

 45 – <60 minutes 

 60 – <90 minutes 

 90 minutes or more
 OMB Number: 0584-0484 

WEB SURVEY Expiration Date: 6/30/2012 

 B-13 National Survey of WIC Participants II 

38. Please record the number of other WIC sites that operate under the authority of this local 

agency, by type. 

___ Clinics (defined as a permanent location assigned to the WIC program) 

___ Satellites (defined as a location such as a school, church or town hall that is only 

temporarily assigned the WIC program each week. WIC staff must carry their own 

files and equipment to the site each week) 

___ Mobile Units (a vehicle assigned to the WIC program that may make multiple stops) 

39. To what extent are certification services provided by your local agency at the various sites 

you specified in the previous question? 

[WEB SURVEY WILL SHOW CLINICS, SATELLITES AND/OR MOBILE UNITS 

COLUMN ONLY IF RESPONDENT HAS ANSWERED >0 IN Q38.] 

Local 

Agency Clinics Satellites Mobile Units 

Agency does 

this 

All 

can do

Some

can do

None 

can do

All 

can do

Some

can do

None 

can do 

All 

can do 

Some

can do

None 

can do 

Conducts certifications          

Performs blood testing          

Takes anthropometric measurements 

for height, weight, and body mass 

index (BMI) 

         

Conducts nutrition counseling          

Offers other educational seminars 

(e.g., on breastfeeding)          

Distributes food instruments          

Provides referrals to other services          

Has access to WIC participant 

records electronically          

Stores paper copies of the WIC 

participant records          
 OMB Number: 0584-0484 

WEB SURVEY Expiration Date: 6/30/2012 

 B-14 National Survey of WIC Participants II 

40. What is the distribution and average allocation of Nutrition Services and Administration 

(NSA) funds across the following functions? 

______% Certification and re-certification 

______% Nutrition education 

______% Breastfeeding promotion and support 

______% Administration 

 100% [TOTAL SHOULD SUM TO 99-101%.] 

STAFF AND CASELOAD 

41. How many staff members work 

for the WIC program at your 

local agency or clinic on a fulltime or part-time basis? 

[PLEASE GIVE NUMBER] 

Number of 

full-time

staff 

(working 32 to 

40+ hours/wk) 

Number of 

part-time

staff 

(working <32 

hours/wk) 

42. Of the total, what 

percentage have worked at 

the agency/clinic less than 

2 years 

a) WIC Director or Clinic Supervisor   ______% 

b) Office Manager   ______% 

c) Administrative Support Staff   ______% 

d) Certification Specialist   ______% 

e) Registered Dietitian   ______% 

f) Degreed/Licensed Nutritionist   ______% 

g) Trained Nutrition Paraprofessional   ______% 

h) Registered Nurse/Physicians Assistant   ______% 

i) Physician   ______% 

j) Social Worker/ Psychologist/ 

Therapist   ______% 

k) Other Professional (non-medical)   ______% 

l) Other: PLEASE SPECIFY 

____________________   ______% 

TOTAL STAFF   ______% 
 OMB Number: 0584-0484 

WEB SURVEY Expiration Date: 6/30/2012 

 B-15 National Survey of WIC Participants II 

43. In all, what is the number of full-time equivalent (FTE) staff who work at your local WIC 

agency or clinic? (IN CALCULATING, NOTE THAT IF THE STANDARD WORK WEEK IS 35-40

HOURS, FTE COULD BE COMPOSED OF 1 FULL TIME EMPLOYEE OR TWO OR MORE PART-TIME 

EMPLOYEES WHO, COMBINED, WORK THAT NUMBER OF HOURS.) 

_____ FTE Staff 

44. What difficulties are faced in retaining, recruiting and hiring staff at your local agency? 

(CHECK ALL THAT APPLY)

 Salaries not competitive 

 Benefits not competitive 

 Minimal training and job growth offered 

 Workload too great 

 Location of local agency unsafe 

 Location of local agency hard to get to 

 Physical space occupied by local agency crowded 

 Low employee morale throughout agency 

 Lack of support for WIC program from State 

 Limited career path or opportunities for promotion 

 Required skillset lacking in prospective employees 

 Other: PLEASE SPECIFY______________________ 

 None of the above 

45. Check off any positions for which your local agency is experiencing moderate or acute 

staffing shortages? (CHECK ALL THAT APPLY)

 Administrative/clerical/support staff 

 Registered Dietitian 

 Degreed/Licensed Nutritionist 

 Trained Nutrition Paraprofessional 

 Registered Nurses/Physicians Assistant 

 Physician 

 Social Worker/ Psychologist/ Therapist 

 Other Professional 

 Other: PLEASE SPECIFY __________ 

 None of the above 
 OMB Number: 0584-0484 

WEB SURVEY Expiration Date: 6/30/2012 

 B-16 National Survey of WIC Participants II 

46. What percentage of WIC applicants and certificants coming to the agency do NOT speak 

English well enough to communicate about eligibility, procedures, nutrition, breastfeeding 

and services? 

 0% 

 1-5% 

 6-10% 

 11-20% 

 21-30% 

 31-40% 

 41-50% 

 51-60% 

 61-70% 

 71-80% 

 81-90% 

 91-100% 

47. What foreign languages are offered by local agency staff? (CHECK ALL THAT APPLY) 

 NONE 

 Arabic 

 Cambodian 

 Cantonese/Mandarin 

 Farsi 

 French/Creole 

 Fulani 

 Hindi 

 Hmong 

 Khmer 

 Korean 

 Laotian 

 Portuguese 

 Punjabi 

 Russian 

 Somali 

 Spanish 

 Swahili 

 Tamil 

 Tagalog 

 Urdu 

 Vietnamese 

 Other: SPECIFY 

_________ 

48. Approximately what percentage of your WIC population (applicants, participants, and 

proxies) are not served by your combined language capabilities? 

_______% 

[IF Q48 MARKED < 10%, SKIP TO Q50] 

46a. How confident are you in the range 

entered here? 

 Very confident 

 Somewhat confident 

 Not very confident 

(i.e., a lot of guesswork involved) 

48a. How confident are you in the 

percentage entered here? 

 Very confident 

 Somewhat confident 

 Not very confident 

(i.e., a lot of guesswork involved)
 OMB Number: 0584-0484 

WEB SURVEY Expiration Date: 6/30/2012 

 B-17 National Survey of WIC Participants II 

49. In what languages does the agency need further support to serve the WIC population? 

(CHECK ALL THAT APPLY) 

 Arabic 

 Cambodian 

 Cantonese/Mandarin 

 Farsi 

 French/Creole 

 Fulani 

 Hindi

 Hmong 

 Khmer 

 Korean 

 Laotian 

 Portuguese 

 Punjabi 

 Russian 

 Somali 

 Spanish 

 Swahili 

 Tamil 

 Tagalog 

 Urdu 

 Vietnamese 

 Other: SPECIFY 

_________ 

PARTICIPANT CHARACTERISTICS 

Thinking of the typical WIC participants served by your local agency each month, please give 

the percentage that fall into the following demographic areas. (PLEASE ROUND 

PERCENTAGES TO NEAREST WHOLE NUMBER. PERCENTAGES MAY TOTAL 99-

101% DUE TO ROUNDING.) 

50. CATEGORY 

___% Pregnant 

___% Breastfeeding 

___% Postpartum 

___% Infants 

___% Children 

100% TOTAL 

51. ETHNICITY 

___% Hispanic or Latino 

___% Not Hispanic or Latino 

100% TOTAL 

52. RACE 

___% American Indian or Alaska Native 

___% Asian American 

___% Black or African American 

___% Native Hawaiian or Other Pacific Islander 

___% White 

___% Multiracial (Two or more of the above) 

100% TOTAL 
 OMB Number: 0584-0484 

WEB SURVEY Expiration Date: 6/30/2012 

 B-18 National Survey of WIC Participants II 

53. OTHER CHARACTERISTICS 

a. What percentage of participants are migrant farm workers _____% 

b. What percentage of participants are homeless _____% 

THIS MARKS THE END OF THE SURVEY. 

THANK YOU VERY MUCH FOR YOUR TIME! 

IF YOU HAVE ANY COMMENTS THAT WERE NOT COVERED IN THE SURVEY, YOU MAY 

PROVIDE THEM BELOW. 

 ______________________________________________________________________________

 ______________________________________________________________________________

 ______________________________________________________________________________

 ______________________________________________________________________________

 ______________________________________________________________________________

 ______________________________________________________________________________

 ______________________________________________________________________________

 ______________________________________________________________________________

 ______________________________________________________________________________

 ______________________________________________________________________________

 ______________________________________________________________________________

 ______________________________________________________________________________

 ______________________________________________________________________________
APPENDIX C: 

DATA TABLES FOR STATE WIC

AGENCY SURVEYS
 C-1 National Survey of WIC Participants II 

Table 1. Type of organization and size, by region 

Number of Participants Type of Organization

Up to 10,000 

%

10,000 to 75,000

%

More than 

75,000 

%

ITO 

%

Territory 

%

State/DC 

%

Total 

%

Region

Northwest 10.3 23.8 6.3 11.1 -- 14.0 12.2 

Mid-Atlantic 3.4 14.3 15.6 -- 40.0 14.0 11.0 

Southeast 3.4 -- 25.0 3.7 -- 16.0 11.0 

Midwest -- -- 15.6 -- -- 10.0 6.1 

Southwest 44.8 4.8 12.5 48.1 -- 10.0 22.0 

Mountain 

Plains 24.1 28.6 12.5 25.9 -- 20.0 20.7 

Western 13.8 28.6 12.5 11.1 60.0 16.0 17.1 

TOTAL NUMBER OF 

AGENCIES 29 21 32 27 5 50 82 

Note: Percentages were calculated for all cases.
 C-2 National Surv

Table 2. Programs that establish adjunctive or other automatic State eligibility for a WIC applicant in a State

Type of Organization Number of Participants Region

ITO 

%

Territory

%

State/DC

%

Up to 

10,000 

%

10,000 

to 

75,000 

%

More 

than 

75,000 

%

Northwest 

%

MidAtlantic 

%

Southeast

%

Midwest

%

Southwes

%

Q1_FS Food Stamps 100.0 80.0 100.0 96.6 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Q1_MD Medicaid 100.0 80.0 100.0 96.6 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Q1_TF TANF 100.0 60.0 98.0 93.1 95.2 100.0 100.0 100.0 100.0 100.0 100.0 Q1_CM Children’s Medicaid 66.7 -- 40.0 58.6 52.4 31.3 50.0 22.2 22.2 40.0 61.1 Q1_SS Supplemental Security Income 40.7 -- 12.0 34.5 14.3 12.5 10.0 11.1 22.2 20.0 22.2 Q1_FR Free and Reduced-Meal School Lunch/Breakfast Program 14.8 -- 16.0 13.8 14.3 15.6 20.0 33.3 -- 40.0 11.1 Q1_FD Food Distribution Program on Indian Reservations 55.6 -- 16.0 44.8 23.8 15.6 20.0 -- 22.2 20.0 33.3 Q1_EA Low-Income Energy Assistance 11.1 -- 4.0 10.3 9.5 -- 20.0 -- -- -- 5.6 Q1_O1 Other programs 1 3.7 -- 18.0 3.4 4.8 25.0 20.0 22.2 -- 60.0 -- Q1_O2 Other programs 2 3.7 -- 10.0 3.4 -- 15.6 20.0 11.1 -- 40.0 -- Q1_NONE None -- 20.0 -- 3.4 -- -- -- -- -- -- -- TOTAL NUMBER OF AGENCIES 27 5 50 29 21 32 10 9 9 5 18 

Note: Percentages were calculated for all cases.
 C-3 National Surv

Table 3. What proofs, if any, the State requires local agencies to collect for establishing adjunctive or other automatic State eligibility

Type of Organization Number of Participants Region

ITO 

%

Territory

%

State/DC

%

Up to 

10,000 

%

10,000 to 

75,000 

%

More than 

75,000 

%

Northwest

%

MidAtlantic 

%

Southeast

%

Midwest

%

Southwest

%

Q1A_FSa Food Stamps: No specific requirements are set 3.7 -- -- 3.4 -- -- -- -- -- -- -- Q1A_FSb Food Stamps: Proof of certification (e.g., card) 51.9 20.0 36.0 48.3 33.3 37.5 40.0 44.4 22.2 40.0 66.7 Q1A_FSc Food Stamps: Award letter 70.4 40.0 62.0 69.0 57.1 62.5 70.0 33.3 44.4 100.0 77.8 Q1A_FSd Food Stamps: Active program voucher 7.4 -- 4.0 6.9 4.8 3.1 10.0 -- 11.1 -- 11.1 Q1A_FSe Food Stamps: Other requirements 3.7 20.0 26.0 3.4 28.6 25.0 10.0 44.4 -- 60.0 11.1 Q1A_MDa Medicaid: No specific requirements are set -- -- -- -- -- -- -- -- -- -- -- Q1A_MDb Medicaid: Proof of certification (e.g., card) 59.3 40.0 56.0 58.6 42.9 62.5 50.0 66.7 55.6 60.0 72.2 Q1A_MDc Medicaid: Award letter 70.4 20.0 42.0 62.1 47.6 40.6 60.0 33.3 22.2 60.0 66.7 Q1A_MDd Medicaid: Active program voucher 7.4 -- 4.0 6.9 9.5 -- 10.0 -- -- -- 11.1 Q1A_MDe Medicaid: Other requirements 3.7 20.0 42.0 3.4 28.6 50.0 30.0 44.4 11.1 60.0 16.7 Q1A_TFa TANF: No specific requirements are set -- -- -- -- -- -- -- -- -- -- -- Q1A_TFb TANF: Proof of certification (e.g., card) 48.1 20.0 36.0 44.8 28.6 40.6 40.0 44.4 33.3 20.0 61.1 Q1A_TFc TANF: Award letter 74.1 20.0 50.0 69.0 47.6 50.0 70.0 33.3 33.3 100.0 77.8 Q1A_TFd TANF: Active program voucher 11.1 -- 4.0 10.3 4.8 3.1 10.0 -- 11.1 -- 11.1 Q1A_TFe TANF: Other requirements -- 20.0 26.0 -- 28.6 25.0 10.0 33.3 -- 40.0 5.6 Q1A_CMa Children’s Medicaid: No specific requirements are set -- -- -- -- -- -- -- -- -- -- -- Q1A_CMb Children’s Medicaid: Proof of certification (e.g., card) 40.7 -- 26.0 37.9 28.6 21.9 20.0 11.1 11.1 40.0 50.0 Q1A_CMc Children’s Medicaid: Award letter 51.9 -- 18.0 48.3 19.0 15.6 40.0 22.2 11.1 20.0 44.4 Q1A_CMd Children’s Medicaid: Active program voucher 7.4 -- 2.0 6.9 4.8 -- 10.0 -- -- -- 11.1 Q1A_CMe Children’s Medicaid: Other requirements -- -- 14.0 -- 9.5 15.6 10.0 -- 11.1 20.0 5.6 Q1A_SSa Supplemental Security Income: No specific requirements are set

-- -- 2.0 -- 4.8 -- 10.0 -- -- -- -- 

Q1A_SSb Supplemental Security Income: Proof of certification (e.g., card)

14.8 -- 6.0 13.8 4.8 6.3 -- 11.1 11.1 -- 11.1 

Q1A_SSc Supplemental Security Income: Award letter 33.3 -- 6.0 31.0 -- 9.4 -- 11.1 11.1 20.0 22.2 Q1A_SSd Supplemental Security Income: Active program voucher 7.4 -- -- 6.9 -- -- -- -- -- -- 11.1 
 C-4 National Surv

Type of Organization Number of Participants Region

ITO 

%

Territory

%

State/DC

%

Up to 

10,000 

%

10,000 to 

75,000 

%

More than 

75,000 

%

Northwest

%

MidAtlantic 

%

Southeast

%

Midwest

%

Southwest

%

Q1A_SSe Supplemental Security Income: Other requirements -- -- -- -- -- -- -- -- -- -- -- Q1A_FRa Free and Reduced-Meal School Lunch/Breakfast Program: No specific requirements are set

11.1 -- 2.0 10.3 4.8 -- 10.0 -- -- -- 5.6 

Q1A_FRb Free and Reduced-Meal School Lunch/Breakfast Program: Proof of certification (e.g., card)

3.7 -- 4.0 3.4 4.8 3.1 -- 11.1 -- -- 5.6 

Q1A_FRc Free and Reduced-Meal School Lunch/Breakfast Program: Award letter

3.7 -- 12.0 3.4 9.5 12.5 10.0 22.2 -- 40.0 5.6 

Q1A_FRd Free and Reduced-Meal School Lunch/Breakfast Program: Active program voucher

3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 

Q1A_FRe Free and Reduced-Meal School Lunch/Breakfast Program: Other requirements

3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 

Q1A_FDa Food Distribution Program on Indian Reservations: No specific requirements are set

7.4 -- 4.0 6.9 9.5 -- 10.0 -- -- -- -- 

Q1A_FDb Food Distribution Program on Indian Reservations: Proof of certification (e.g., card)

25.9 -- 8.0 24.1 4.8 9.4 -- -- 22.2 -- 22.2 

Q1A_FDc Food Distribution Program on Indian Reservations: Award letter

25.9 -- 2.0 20.7 4.8 3.1 10.0 -- -- -- 16.7 

Q1A_FDd Food Distribution Program on Indian Reservations: Active program voucher

3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 

Q1A_FDe Food Distribution Program on Indian Reservations: Other requirements

-- -- 2.0 -- -- 3.1 -- -- -- 20.0 -- 

Q1A_EAa Low-Income Energy Assistance: No specific requirements are set

3.7 -- 2.0 3.4 4.8 -- 10.0 -- -- -- -- 

Q1A_EAb Low-Income Energy Assistance: Proof of certification (e.g., card)

3.7 -- 2.0 3.4 4.8 -- -- -- -- -- 5.6 

Q1A_EAc Low-Income Energy Assistance: Award letter 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 Q1A_EAd Low-Income Energy Assistance: Active program voucher

3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 

Q1A_EAe Low-Income Energy Assistance: Other requirements -- -- -- -- -- -- -- -- -- -- -- Q1A_O1a Other programs 1: No specific requirements are set -- -- -- -- -- -- -- -- -- -- -- Q1A_O1b Other programs 1: Proof of certification (e.g., card) -- -- 6.0 -- 4.8 6.3 -- 11.1 -- 20.0 -- 
 C-5 National Surv

Type of Organization Number of Participants Region

ITO 

%

Territory

%

State/DC

%

Up to 

10,000 

%

10,000 to 

75,000 

%

More than 

75,000 

%

Northwest

%

MidAtlantic 

%

Southeast

%

Midwest

%

Southwest

%

Q1A_O1c Other programs 1: Award letter -- -- 14.0 -- 4.8 18.8 10.0 -- -- 60.0 -- Q1A_O1d Other programs 1: Active program voucher -- -- -- -- -- -- -- -- -- -- -- Q1A_O1e Other programs 1: Other requirements -- -- 4.0 -- -- 6.3 -- -- -- 40.0 -- Q1A_O2a Other programs 2: No specific requirements are set -- -- -- -- -- -- -- -- -- -- -- Q1A_O2b Other programs 2: Proof of certification (e.g., card) -- -- 4.0 -- -- 6.3 -- 11.1 -- 20.0 -- Q1A_O2c Other programs 2: Award letter -- -- 2.0 -- -- 3.1 -- -- -- 20.0 -- Q1A_O2d Other programs 2: Active program voucher -- -- -- -- -- -- -- -- -- -- -- Q1A_O2e Other programs 2: Other requirements -- -- 8.0 -- -- 12.5 10.0 -- -- 40.0 -- TOTAL NUMBER OF AGENCIES 27 5 50 29 21 32 10 9 9 5 18 

Note: Percentages were calculated for all cases.
 C-6 National Surv

Table 4. The programs with adjunctive or other automatic State eligibility that allow to participate people whose income may exceed the normal “185 of the federal 

Type of Organization Number of Participants Region

ITO 

%

Territory 

%

State/

DC 

%

Up to 

10,000 

%

10,000 to 

75,000 

%

More than 

75,000 

%

Northwest 

%

MidAtlantic 

%

Southeast 

%

Midwest 

%

Southwest 

%

Q2 Do any of the programs that establish adjunctive or other automatic State eligibility allow to participate people whose income may exceed the normal “185 of the federal poverty level” income standard?

YES 33.3 40.0 58.0 34.5 61.9 53.1 70.0 44.4 66.7 60.0 22.2 

NO 66.7 60.0 42.0 65.5 38.1 46.9 30.0 55.6 33.3 40.0 77.8 

Q2A_FS Food Stamps 25.9 40.0 18.0 31.0 9.5 21.9 10.0 11.1 22.2 -- 16.7 Q2A_MD Medicaid 29.6 40.0 46.0 31.0 38.1 50.0 50.0 33.3 66.7 60.0 16.7 Q2A_TF TANF 25.9 40.0 16.0 31.0 9.5 18.8 -- 11.1 22.2 -- 22.2 Q2A_CM Children’s Medicaid 22.2 -- 26.0 20.7 42.9 12.5 30.0 11.1 -- 40.0 22.2 Q2A_O Other program 7.4 -- 6.0 6.9 4.8 6.3 10.0 11.1 -- -- -- Q2A_SS Supplemental Security Income 14.8 -- -- 13.8 -- -- -- -- -- -- 5.6 Q2A_FR Free and Reduced-Meal School Lunch/Breakfast Program 11.1 -- -- 10.3 -- -- -- -- -- -- 5.6 Q2A_FD Food Distribution Program on Indian Reservations 18.5 -- 2.0 17.2 -- 3.1 -- -- -- -- 5.6 Q2A_EA Low-Income Energy Assistance 7.4 -- -- 6.9 -- -- -- -- -- -- 5.6 TOTAL NUMBER OF AGENCIES 27 5 50 29 21 32 10 9 9 5 18 

Note: Percentages were calculated for all cases.
 C-7 National Surv

Table 5. When adjunctive/automatic eligibility is NOT established, what sources of income does a State require local agencies to count when determining the incom

Type of Organization Number of Participants Region

ITO 

%

Territory

%

State/DC

%

Up to 

10,000 

%

10,000 to 

75,000 

%

More than 

75,000 

%

Northwest

%

MidAtlantic 

%

Southeast

%

Midwest

%

Southwest

%

Q3_WS Wages, salary, fees 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Q3_TB Tips and bonuses 51.9 40.0 96.0 48.3 95.2 93.8 80.0 77.8 88.9 100.0 77.8 Q3_SE Self-employment 92.6 100.0 100.0 93.1 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Q3_UC Unemployment compensation 92.6 40.0 100.0 82.8 100.0 100.0 100.0 88.9 100.0 100.0 94.4 Q3_WC Workers compensation 74.1 40.0 90.0 65.5 90.5 90.6 80.0 77.8 88.9 60.0 94.4 Q3_CS Child support 85.2 80.0 100.0 82.8 100.0 100.0 80.0 100.0 100.0 100.0 100.0 Q3_CM Commissions 44.4 60.0 90.0 44.8 81.0 93.8 80.0 66.7 88.9 100.0 66.7 Q3_PA Public assistance 63.0 80.0 88.0 62.1 90.5 87.5 70.0 77.8 55.6 100.0 72.2 Q3_AL Alimony 55.6 80.0 98.0 55.2 95.2 100.0 80.0 100.0 100.0 100.0 83.3 Q3_SS Social Security 85.2 100.0 98.0 86.2 95.2 100.0 90.0 100.0 100.0 100.0 88.9 Q3_PP Private pension 48.1 60.0 98.0 48.3 90.5 100.0 80.0 88.9 100.0 100.0 66.7 Q3_DP Disability pension 59.3 40.0 92.0 58.6 90.5 87.5 80.0 77.8 88.9 80.0 72.2 Q3_MA Medical assistance 11.1 20.0 38.0 13.8 52.4 25.0 20.0 33.3 44.4 -- 16.7 Q3_SSF Supplemental Security Income—Federal government 66.7 40.0 90.0 65.5 85.7 87.5 80.0 66.7 66.7 100.0 83.3 Q3_SSS Supplemental Security Income—State-issued 59.3 20.0 90.0 55.2 90.5 84.4 80.0 77.8 77.8 80.0 77.8 Q3_IE Income from estates 44.4 40.0 94.0 44.8 90.5 90.6 80.0 77.8 88.9 100.0 66.7 Q3_Nro Net royalties 40.7 20.0 92.0 37.9 76.2 96.9 80.0 66.7 100.0 100.0 72.2 Q3_OC Other cash income 59.3 80.0 92.0 58.6 90.5 93.8 70.0 100.0 100.0 80.0 72.2 Q3_EA Energy assistance 3.7 20.0 32.0 6.9 42.9 21.9 10.0 22.2 22.2 -- -- Q3_RA Rental assistance -- 20.0 36.0 3.4 42.9 28.1 10.0 22.2 22.2 20.0 -- Q3_Nre Net rental income 37.0 60.0 82.0 41.4 71.4 84.4 60.0 55.6 100.0 80.0 55.6 Q3_DI Dividends or interest from savings 44.4 -- 92.0 37.9 85.7 90.6 80.0 66.7 88.9 100.0 66.7 Q3_RC Regular contributions from persons not in household 51.9 80.0 100.0 55.2 95.2 100.0 80.0 100.0 100.0 100.0 72.2 Q3_IT Income from trusts 37.0 60.0 96.0 37.9 95.2 93.8 80.0 88.9 88.9 100.0 61.1 Q3_WF Welfare 48.1 40.0 88.0 44.8 85.7 87.5 90.0 77.8 66.7 100.0 55.6 Q3_O Other 14.8 -- 26.0 6.9 23.8 31.3 -- 22.2 22.2 40.0 5.6 TOTAL NUMBER OF AGENCIES 27 5 50 29 21 32 10 9 9 5 18 

Note: Percentages were calculated for all cases. 
 C-8 National Surv

Table 6. In determining the income of an applicant, where unemployment is not an issue, how does the State instruct local agencies to use income 

Type of Organization Number of Participants Reg

ITO 

%

Territory

%

State/

DC 

%

Up to 

10,000 

%

10,000 

to 

75,000 

%

More 

than 

75,000 

%

Northwest

%

MidAtlantic

%

Southeast

%

Midwest

%

Q4 In determining the income of an applicant, where unemployment is not an issue, which procedure does the State use?

Income from last year used 3.7 -- 4.0 3.4 -- 6.3 -- -- 11.1 20.0 Current income used 81.5 100.0 48.0 86.2 47.6 50.0 30.0 77.8 33.3 20.0 Left to local agencies to decide 7.4 -- 18.0 3.4 23.8 15.6 40.0 11.1 11.1 40.0 Other 7.4 -- 30.0 6.9 28.6 28.1 30.0 11.1 44.4 20.0 

TOTAL NUMBER OF AGENCIES 27 5 50 29 21 32 10 9 9 5 

Note: Percentages were calculated for all cases.
 C-9 National Surv

Table 7. What types of proof are acceptable in a State to verify the sources of income for WIC applicants

Type of Organization Number of Participants Region

ITO 

%

Territory

%

State/DC

%

Up to 

10,000

%

10,000 

to 

75,000

%

More 

than 

75,000

%

Northwest 

%

MidAtlantic

%

Southeast

%

Midwest

%

Southwe

%

Q5tax Most recent tax return 88.9 80.0 96.0 89.7 95.2 93.8 100.0 77.8 100.0 100.0 88.9 Q5chk Check or pay stubs 100.0 100.0 96.0 100.0 95.2 96.9 100.0 88.9 100.0 100.0 100.0 Q5ss Signed statement by employer 88.9 100.0 96.0 89.7 95.2 96.9 90.0 88.9 100.0 100.0 100.0 Q5sob Statement of benefits by public agency or court 70.4 80.0 94.0 75.9 85.7 93.8 80.0 77.8 100.0 100.0 77.8 Q5sob2 Statement of benefits for child support and alimony 77.8 80.0 94.0 75.9 90.5 96.9 80.0 88.9 100.0 100.0 94.4 Q5leave Leave and Earnings Statement (LES) for military pay 70.4 60.0 96.0 72.4 90.5 93.8 90.0 77.8 100.0 100.0 88.9 Q5unemploy Unemployment letter or notice letter signed by official State/local agency attesting to client’s low income 

81.5 80.0 88.0 82.8 85.7 87.5 90.0 88.9 88.9 80.0 83.3 

Q5writ Written statement from reliable third party 48.1 80.0 82.0 51.7 71.4 87.5 80.0 88.9 100.0 80.0 66.7 Q5bank Statement from bank or other financial institution savings (e.g., direct deposit) 59.3 60.0 80.0 65.5 61.9 84.4 90.0 66.7 88.9 100.0 66.7 Q5acctg Accounting records (for self-employed individuals) 51.9 80.0 78.0 55.2 61.9 87.5 70.0 77.8 100.0 100.0 66.7 Q5schol Scholarship letter (e.g., for students) 51.9 20.0 66.0 44.8 57.1 71.9 70.0 44.4 88.9 80.0 66.7 Q5_O Other 7.4 -- 16.0 -- 23.8 15.6 -- 33.3 -- 40.0 -- Q5_NONE None -- -- 2.0 -- 4.8 -- -- -- -- -- -- Q5A_txt How does the State determine 'most recent' income? 

Previous/current (calendar) month (30 days) 14.8 40.0 42.0 20.7 57.1 28.1 20.0 55.6 55.6 40.0 22.2 Previous 60 days 14.8 -- 4.0 13.8 -- 6.3 -- -- 11.1 -- 22.2 Previous 12 months -- -- 12.0 -- 4.8 15.6 -- -- -- -- 5.6 Current/Latest pay stub, earning statement 40.7 20.0 36.0 41.4 19.0 43.8 60.0 33.3 33.3 60.0 27.8 Previous 90 days -- 40.0 4.0 3.4 4.8 6.3 10.0 11.1 -- -- 5.6 N/A 29.6 -- 2.0 20.7 14.3 -- 10.0 -- -- -- 16.7 

TOTAL NUMBER OF AGENCIES 27 5 50 29 21 32 10 9 9 5 18 

Note: Percentages were calculated for all cases. 
 C-10 National Surv

Table 8. State or local income guidelines used for WIC

Type of Organization Number of Participants Region

ITO 

%

Territory

%

State/DC

%

Up to 

10,000

%

10,000 

to 

75,000

%

More 

than 

75,000

%

Northwest 

%

MidAtlantic

%

Southeast

%

Midwest

%

Southwe

%

Q6 Does the State use or grant discretion to local agencies regarding income determination?

YES 55.6 60.0 52.0 58.6 38.1 59.4 30.0 55.6 44.4 80.0 66.7 NO 44.4 40.0 48.0 41.4 61.9 40.6 70.0 44.4 55.6 20.0 33.3 

Q6A State or local income guidelines used for WIC are adopted from which of the following services?

Free and Reduced Health Care (e.g., Maternal Health Care, Pediatric Health Care)

11.1 -- 16.0 6.9 23.8 12.5 10.0 22.2 11.1 40.0 11.1 

Free and Reduced Priced School Meals 33.3 20.0 26.0 31.0 38.1 18.8 50.0 11.1 22.2 20.0 33.3 Other 22.2 40.0 28.0 27.6 19.0 31.3 20.0 33.3 22.2 20.0 27.8 None 33.3 40.0 30.0 34.5 19.0 37.5 20.0 33.3 44.4 20.0 27.8 

Q6A_A Percentage of federal poverty level

180 -- 20.0 -- 3.4 -- -- -- -- -- -- -- 185 81.5 40.0 84.0 75.9 85.7 81.3 90.0 88.9 77.8 60.0 88.9 200 -- -- 4.0 -- 4.8 3.1 -- -- -- 20.0 -- None 18.5 40.0 12.0 20.7 9.5 15.6 10.0 11.1 22.2 20.0 11.1 

TOTAL NUMBER OF AGENCIES 27 5 50 29 21 32 10 9 9 5 18 

Note: Percentages were calculated for all cases.
 C-11 National Surv

Table 9. Certification of applicants who are not likely to have any proof of income

Type of Organization Number of Participants Regi

ITO 

%

Territory

%

State/ 

DC 

%

Up to 

10,000 

%

10,000 

to 

75,000 

%

More 

than 

75,000 

%

Northwest

%

MidAtlantic

%

Southeast

%

Midwest

%

Q7 For applicants not likely to have any proof of income does the State allow self-declaration of income with applicants signed statement of why documentation cannot be provided?

YES 96.3 100.0 98.0 96.6 100.0 96.9 90.0 100.0 100.0 100.0 NO 3.7 -- 2.0 3.4 -- 3.1 10.0 -- -- -- 

Q8 When an infant turns 1 year, does the 6-month certification period remain valid, or does the infant become categorically ineligible and need to again be certified based on criteria used for children?

The 6-month certification period remains valid

22.2 40.0 40.0 17.2 42.9 43.8 40.0 22.2 22.2 80.0 

The infant becomes categorically ineligible and needs to again be certified

74.1 40.0 48.0 75.9 38.1 50.0 40.0 77.8 77.8 20.0 

Neither: There is no State policy, Discretion is given to local agencies

3.7 20.0 12.0 6.9 19.0 6.3 20.0 -- -- -- 

TOTAL NUMBER OF AGENCIES 27 5 50 29 21 32 10 9 9 5 

Note: Percentages were calculated for all cases.
 C-12 National Surv

Table 10. Characteristics of the certification periods

Type of Organization Number of Participants Region

ITO 

%

Territory 

%

State/DC

%

Up to 

10,000

%

10,000 

to 

75,000

%

More 

than 

75,000

%

Northwest 

%

MidAtlantic

%

Southeast

%

Midwest

%

Southwe

%

Q9 Does your State use a data month or calendar month for issuance cycles?

Calendar month 48.1 40.0 24.0 48.3 14.3 31.3 40.0 11.1 55.6 20.0 33.3 Data month 51.9 60.0 76.0 51.7 85.7 68.8 60.0 88.9 44.4 80.0 66.7 

Q10 For temporary lowincome persons, does the State allow the full certification period or shorten the certification period based on anticipated income increase?

Allows full certification period 74.1 80.0 92.0 72.4 90.5 93.8 80.0 77.8 88.9 100.0 72.2 Shortens certification period based on anticipated income increase

22.2 20.0 4.0 24.1 4.8 3.1 10.0 11.1 11.1 -- 27.8 

N/A 3.7 -- 4.0 3.4 4.8 3.1 10.0 11.1 -- -- -- 

Q11 What other discretion, if any, does the State use or grant to local agencies regarding certification periods?

No additional discretion is given 85.2 60.0 66.0 86.2 57.1 68.8 80.0 88.9 66.7 60.0 83.3 Other discretion is given 14.8 40.0 34.0 13.8 42.9 31.3 20.0 11.1 33.3 40.0 16.7 

TOTAL NUMBER OF AGENCIES 27 5 50 29 21 32 10 9 9 5 18 

Note: Percentages were calculated for all cases.
 C-13 National Surv

Table 11. Additional guidelines, if any, that are given by the State to local agencies to help them determine the WIC economic/family unit

Type of Organization Number of Participants Region

ITO 

%

Territory

%

State/

DC 

%

Up to 

10,000 

%

10,000 

to 

75,000 

%

More 

than 

75,000 

%

Northwest 

%

MidAtlantic 

%

Southeast

%

Midwest

%

Southwe

%

Q12 What additional guidelines, if any, are given by the State to local agencies to help them determine the WIC economic/family unit above and beyond the national WIC program definition?

No additional discretion is given 81.5 80.0 44.0 82.8 38.1 50.0 70.0 77.8 55.6 20.0 83.3 The discretion is given 18.5 20.0 56.0 17.2 61.9 50.0 30.0 22.2 44.4 80.0 16.7 

Q12_O_txt Specify the discretion

NO ADDITIONAL DISCRETION IS GIVEN 81.5 80.0 44.0 82.8 38.1 50.0 70.0 77.8 55.6 20.0 83.3 "Staff will determine the family size unit which will be used to determine income eligibility."

-- -- 2.0 -- 4.8 -- -- -- -- -- 5.6 

Sharing economic resources and consumption of goods 3.7 20.0 20.0 6.9 9.5 25.0 -- 11.1 11.1 20.0 5.6 Excluding residents of a homeless facility or institution 3.7 -- 4.0 3.4 9.5 -- 10.0 -- -- -- 5.6 No supporting documents provided -- -- 8.0 -- 4.8 9.4 10.0 -- 11.1 20.0 -- Sharing economic resources/consumption of goods AND excluding residents of a homeless facility or institution

-- -- 10.0 -- 14.3 6.3 10.0 -- -- 20.0 -- 

810.3.4 Family size/Household Units to qualify as separate economic units, applicant must have an adequate source of income and usually purchase/prepare food separately.

-- -- 2.0 -- 4.8 -- -- -- -- -- -- 

More than one economic unit may reside in the same house. Separate economic units in the same house are characterized by splitting expenses and maintaining economic independence from one another.

-- -- 2.0 -- 4.8 -- -- -- -- -- -- 

Multiple definitions -- -- 2.0 -- -- 3.1 -- -- -- 20.0 -- Multiple qualifications 3.7 -- 2.0 3.4 -- 3.1 -- -- 22.2 -- -- no supporting documents provided 3.7 -- 4.0 -- 9.5 3.1 -- 11.1 -- -- -- We are both local and State agency (ITO %) 3.7 -- -- 3.4 -- -- -- -- -- -- -- 

TOTAL NUMBER OF AGENCIES 27 5 50 29 21 32 10 9 9 5 18 

Note: Percentages were calculated for all cases.
 C-14 National Surv

Table 12. In determining household income, the State excludes the following military housing allowances

Type of Organization Number of Participants Region

ITO 

%

Territory

%

State/

DC 

%

Up to 

10,000 

%

10,000 

to 

75,000 

%

More 

than 

75,000 

%

Northwest 

%

MidAtlantic 

%

Southeast

%

Midwest

%

Southwes

%

Q13_BAH Basic Allowance for Housing (BAH) for off-base housing and privatization housing in the U.S.

51.9 80.0 90.0 55.2 81.0 93.8 70.0 88.9 88.9 100.0 72.2 

Q13_FSH Family Separation Housing (FSH) provided to military personnel for overseas housing. 

37.0 40.0 62.0 37.9 57.1 62.5 60.0 33.3 77.8 80.0 44.4 

Q13_OHA Overseas Housing Allowance (OHA) provided to military personnel living overseas. 37.0 40.0 66.0 37.9 61.9 65.6 60.0 33.3 77.8 80.0 44.4 Q13_OCON Overseas Continental U.S. (OCONUS) cost of living allowance (COLA) provided to active duty uniformed service members in Hawaii, Alaska, and Guam.

44.4 60.0 74.0 48.3 71.4 71.9 60.0 66.7 77.8 80.0 55.6 

Q13_none None 40.7 20.0 8.0 37.9 14.3 6.3 30.0 11.1 11.1 -- 22.2 TOTAL NUMBER OF AGENCIES 27 5 50 29 21 32 10 9 9 5 18 

Note: Percentages were calculated for all cases. 
 C-15 National Surv

Table 13. Children in temporary care of friends/relatives

Type of Organization Number of Participants Region

ITO 

%

Territory

%

State/

DC 

%

Up to 

10,000

%

10,000 

to 

75,000

%

More 

than 

75,000

%

Northwest 

%

MidAtlantic

%

Southeast

%

Midwest

%

Southwe

%

Q14 Regarding Children in Temporary Care of Friends/Relatives, does the State:

Count absent parents and children as one unit 11.1 -- 8.0 10.3 9.5 6.3 10.0 22.2 -- -- 16.7 Count the children as a separate unit in which case they should have separate income

70.4 40.0 20.0 65.5 14.3 28.1 30.0 33.3 44.4 60.0 44.4 

Count the children as part of the economic unit of the person with whom they are residing

11.1 60.0 56.0 17.2 57.1 53.1 30.0 44.4 33.3 20.0 38.9 

None of the above 7.4 -- 16.0 6.9 19.0 12.5 30.0 -- 22.2 20.0 -- 

TOTAL NUMBER OF AGENCIES 27 5 50 29 21 32 10 9 9 5 18 

Note: Percentages were calculated for all cases.
 C-16 National Surv

Table 14. Types of identification that are acceptable in a State to verify the residency of a WIC applicant

Type of Organization Number of Participants Region

ITO 

%

Territory

%

State/DC

%

Up to 

10,000 

%

10,000 

to 

75,000 

%

More 

than 

75,000 

%

Northwest 

%

MidAtlantic

%

Southeast

%

Midwest

%

Southwes

%

Q15_DL Driver’s license 66.7 100.0 72.0 69.0 76.2 71.9 90.0 100.0 66.7 80.0 44.4 Q15_UB Current utility/tax bill with address on it 88.9 100.0 94.0 89.7 95.2 93.8 80.0 100.0 88.9 100.0 94.4 Q15_WS Written statement from reliable third party 63.0 60.0 60.0 62.1 61.9 59.4 80.0 55.6 55.6 80.0 66.7 Q15_CK Checkbook 7.4 20.0 26.0 10.3 28.6 21.9 40.0 11.1 11.1 20.0 5.6 Q15_ST Signed statement by applicant that he/she is victim of loss or disaster, or is homeless, a migrant person, or military personnel

48.1 60.0 86.0 44.8 85.7 87.5 60.0 88.9 66.7 100.0 66.7 

Q15_RR Rent receipt, mortgage receipt, or lease 81.5 100.0 88.0 82.8 95.2 84.4 80.0 88.9 77.8 100.0 83.3 Q15_O1XD Other 37.0 40.0 68.0 31.0 57.1 78.1 60.0 44.4 55.6 100.0 50.0 Q15_O1 Other 1

Any document with current address 3.7 -- 10.0 3.4 4.8 12.5 10.0 11.1 11.1 20.0 -- Bank statement 3.7 -- 4.0 -- 4.8 6.3 -- -- 22.2 -- -- Birth certificate -- -- 2.0 -- -- 3.1 -- -- -- 20.0 -- Government, official, or business mail with address and postmark 3.7 20.0 12.0 3.4 19.0 9.4 10.0 22.2 -- -- 11.1 Food Stamp/SNAP/Medicaid eligibility notice -- -- 18.0 -- 19.0 15.6 20.0 -- 11.1 20.0 16.7 Income tax return -- -- 2.0 -- -- 3.1 -- -- -- -- -- Map and WIC Form R02 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 Pay check/stub with name, address -- -- 4.0 -- -- 6.3 10.0 -- -- -- -- Social Service letter (e.g., church, shelter) 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 State/Tribe-issued ID card 14.8 -- 2.0 13.8 -- 3.1 -- -- -- -- 5.6 State/local document that can only obtained with proof of address

-- -- 4.0 -- 4.8 3.1 10.0 -- -- -- -- 

Student records with name, address -- -- 2.0 -- -- 3.1 -- -- 11.1 -- -- Voter registration 3.7 20.0 4.0 3.4 4.8 6.3 -- -- -- 20.0 5.6 Rent, mortgage, lease agreement -- -- 4.0 -- -- 6.3 -- 11.1 -- 20.0 -- 
 C-17 National Surv

Type of Organization Number of Participants Region

ITO 

%

Territory

%

State/DC

%

Up to 

10,000 

%

10,000 

to 

75,000 

%

More 

than 

75,000 

%

Northwest 

%

MidAtlantic

%

Southeast

%

Midwest

%

Southwes

%

Q15_O2 Other 2 

Any document with current address -- -- 8.0 -- 4.8 9.4 10.0 11.1 -- 20.0 -- Government, official, or business mail with address and postmark 3.7 -- 4.0 3.4 -- 6.3 -- 11.1 -- -- 5.6 Car registration/insurance -- -- 6.0 -- 4.8 6.3 -- -- 11.1 20.0 -- Food Stamp/SNAP/Medicaid eligibility notice -- 20.0 4.0 -- 4.8 6.3 10.0 11.1 -- -- 5.6 Hospital records -- -- 4.0 -- -- 6.3 -- -- 11.1 20.0 -- Income tax return 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 Map and WIC Form R02 3.7 -- -- 3.4 -- -- -- -- -- -- -- Passport/Visa/Immigration documents -- -- 2.0 -- -- 3.1 -- -- -- 20.0 -- Pay check/stub with name, address 3.7 -- 4.0 -- 9.5 3.1 -- -- 11.1 -- -- Social service letter (e.g., church, shelter) -- 20.0 4.0 3.4 4.8 3.1 -- -- -- -- 5.6 State/Tribe-issued ID card 11.1 -- 2.0 10.3 -- 3.1 -- -- 11.1 -- 5.6 Student records with name, address -- -- 2.0 -- -- 3.1 10.0 -- -- -- -- Voter registration -- -- 4.0 -- -- 6.3 -- -- -- -- 5.6 Rent, mortgage, lease agreement -- -- 2.0 -- -- 3.1 10.0 -- -- -- -- 

Q15_O3 Other 3

Any document with current address -- -- 4.0 -- 4.8 3.1 10.0 -- -- -- -- Bank statement -- -- 4.0 -- 4.8 3.1 -- -- -- -- -- Birth certificate 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 Government, official, or business mail with address and postmark -- -- 2.0 -- -- 3.1 -- -- -- 20.0 -- Food Stamp/SNAP/Medicaid eligibility notice -- -- 6.0 -- -- 9.4 -- 11.1 11.1 -- -- Hospital records -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- Income tax return -- -- 2.0 -- -- 3.1 -- -- -- -- 5.6 Marriage license -- -- 2.0 -- -- 3.1 -- -- -- 20.0 -- Passport/Visa/Immigration documents -- -- 2.0 -- -- 3.1 -- -- -- -- 5.6 Pay check/stub with name, address -- -- 2.0 -- 4.8 -- 10.0 -- -- -- -- Social service letter (e.g., church, shelter) 3.7 -- 2.0 3.4 -- 3.1 -- -- -- -- -- State/Tribe-issued ID card 3.7 -- 2.0 -- 4.8 3.1 -- -- 11.1 -- -- Student records with name, address -- -- 2.0 -- -- 3.1 -- -- 11.1 -- -- 
 C-18 National Surv

Type of Organization Number of Participants Region

ITO 

%

Territory

%

State/DC

%

Up to 

10,000 

%

10,000 

to 

75,000 

%

More 

than 

75,000 

%

Northwest 

%

MidAtlantic

%

Southeast

%

Midwest

%

Southwes

%

Q15_O4 Other 4

Government, official, or business mail with address and postmark -- -- 4.0 -- -- 6.3 10.0 11.1 -- -- -- Car registration/insurance 3.7 -- 2.0 3.4 -- 3.1 -- -- -- -- -- Hospital records 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 Map and WIC Form R02 -- -- 4.0 -- -- 6.3 -- -- 11.1 -- 5.6 Passport/Visa/Immigration documents -- -- 2.0 -- 4.8 -- 10.0 -- -- -- -- Social service letter (e.g., church, shelter) -- -- 2.0 -- 4.8 -- -- -- -- -- -- State/Tribe-issued ID card -- -- 4.0 -- -- 6.3 -- -- -- 20.0 5.6 State/local document that can only obtained with proof of address

-- -- 2.0 -- -- 3.1 -- -- -- -- -- 

Voter registration -- -- 2.0 -- -- 3.1 -- -- 11.1 -- -- Rent, mortgage, lease agreement -- -- 2.0 -- -- 3.1 -- -- 11.1 -- -- 

Q15_O5 Other 5

Any document with current address 3.7 -- -- 3.4 -- -- -- -- -- -- -- Bank statement -- -- 2.0 -- -- 3.1 -- -- 11.1 -- -- Government, official, or business mail with address and postmark -- -- 2.0 -- -- 3.1 -- -- 11.1 -- -- Food Stamp/SNAP/Medicaid eligibility notice -- -- 2.0 -- -- 3.1 10.0 -- -- -- -- Hospital records -- -- 2.0 -- -- 3.1 -- -- -- -- 5.6 Passport/Visa/Immigration documents -- -- 2.0 -- -- 3.1 -- -- -- 20.0 -- Pay check/stub with name, address -- -- 2.0 -- -- 3.1 -- -- -- -- -- Social service letter (e.g., church, shelter) -- -- 2.0 -- -- 3.1 -- -- -- -- 5.6 Voter registration -- -- 4.0 -- 4.8 3.1 10.0 -- 11.1 -- -- 

Q15_O6 No response

1.00 -- -- 4.0 -- 4.8 3.1 -- -- 11.1 -- -- 

TOTAL NUMBER OF AGENCIES 27 5 50 29 21 32 10 9 9 5 18 

Note: Percentages were calculated for all cases. 
 C-19 National Surv

Table 15. Residency requirements

Type of Organization Number of Participants Region

ITO 

%

Territory

%

State/

DC 

%

Up to 

10,000

%

10,000 

to 

75,000

%

More 

than 

75,000

%

Northwest 

%

MidAtlantic

%

Southeast

%

Midwest

%

Southwe

%

Q16 Does the State require applicants to reside within the State to be eligible for WIC?

YES 74.1 100.0 100.0 79.3 95.2 100.0 100.0 100.0 100.0 100.0 83.3 NO 25.9 -- -- 20.7 4.8 -- -- -- -- -- 16.7 

Q17 Do local agencies (i.e. the umbrella agencies above the local clinics) have nonoverlapping jurisdictions with one another?

YES 33.3 -- 46.0 31.0 42.9 43.8 70.0 22.2 77.8 40.0 33.3 NO 66.7 100.0 54.0 69.0 57.1 56.3 30.0 77.8 22.2 60.0 66.7 

Q18 Check the statement that best describes your residency requirements for WIC participants:

WIC participants must reside within the boundary of the WIC local clinic where she/he resides

25.9 20.0 2.0 24.1 4.8 3.1 30.0 11.1 11.1 -- 5.6 

WIC participants must reside within the boundary of the WIC local agency (overseeing the clinic) where she/he resides

7.4 20.0 14.0 6.9 19.0 12.5 10.0 11.1 -- 20.0 11.1 

WIC participants only need to show that they live somewhere within the State

40.7 60.0 66.0 44.8 66.7 62.5 50.0 55.6 66.7 40.0 61.1 

The decision is left to local agencies and/or clinics

14.8 -- 14.0 13.8 4.8 18.8 -- 11.1 22.2 20.0 11.1 

Other 11.1 -- 4.0 10.3 4.8 3.1 10.0 11.1 -- 20.0 11.1 

TOTAL NUMBER OF AGENCIES 27 5 50 29 21 32 10 9 9 5 18 

Note: Percentages were calculated for all cases.
 C-20 National Surv

Table 16. Review of the records of WIC participants to identify duplicate certifications

Type of Organization Number of Participants Region

ITO 

%

Territory

%

State/

DC 

%

Up to 

10,000

%

10,000 

to 

75,000

%

More 

than 

75,000

%

Northwest 

%

MidAtlantic

%

Southeast

%

Midwest

%

Southwe

%

Q19 How often does the State regularly review the records of WIC participants to identify duplicate certifications across local agencies? 

Process is automated and constant 40.7 100.0 76.0 48.3 71.4 78.1 60.0 88.9 66.7 100.0 66.7 10-12 times a year (e.g., monthly) 3.7 -- 10.0 3.4 9.5 9.4 -- 11.1 11.1 -- -- 7-9 times a year -- -- -- -- -- -- -- -- -- -- -- 4-6 times a year (e.g., quarterly) 29.6 -- 6.0 27.6 9.5 3.1 10.0 -- 11.1 -- 33.3 2-3 times a year (e.g., semiannually) 11.1 -- 4.0 10.3 4.8 3.1 10.0 -- -- -- -- Once a year or less 7.4 -- 2.0 6.9 -- 3.1 10.0 -- 11.1 -- -- Never -- -- -- -- -- -- -- -- -- -- -- Don’t know 7.4 -- 2.0 3.4 4.8 3.1 10.0 -- -- -- -- 

TOTAL NUMBER OF AGENCIES 27 5 50 29 21 32 10 9 9 5 18 

Note: Percentages were calculated for all cases.
 C-21 National Surv

Table 17. Nutritional eligibility assessment

Type of Organization Number of Participants Region

ITO 

%

Territory

%

State/DC

%

Up to 

10,000 

%

10,000 

to 

75,000 

%

More 

than 

75,000 

%

Northwest 

%

MidAtlantic

%

Southeast

%

Midwest

%

Southwe

%

Q20 20. At the current time, does your State use FNS’s WIC Nutrition Risk Criteria to ascertain nutritional eligibility or does the State bundle the codes into its own unique groupings?

Use FNS criteria 100.0 100.0 70.0 100.0 66.7 75.0 80.0 66.7 66.7 80.0 88.9 Bundle codes -- -- 10.0 -- 19.0 3.1 -- 33.3 -- -- 5.6 Other -- -- 20.0 -- 14.3 21.9 20.0 -- 33.3 20.0 5.6 

Q22 When does your State plan to have the VENA (Value Enhanced Nutrition Assessment) protocols fully implemented at the local level?

It is already implemented 70.4 80.0 62.0 72.4 61.9 62.5 70.0 22.2 44.4 100.0 83.3 By end of 2009 11.1 -- 20.0 10.3 9.5 25.0 -- 33.3 44.4 -- 16.7 By end of 2010 7.4 -- 12.0 6.9 19.0 6.3 10.0 22.2 -- -- -- Later than 2010 -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- Don’t know 11.1 20.0 4.0 10.3 9.5 3.1 20.0 11.1 11.1 -- -- 

TOTAL NUMBER OF AGENCIES 27 5 50 29 21 32 10 9 9 5 18 

Note: Percentages were calculated for all cases.
 C-22 National Surv

Table 18. Nutritional risk code indicators used in a State

Type of Organization Number of Participants Region

ITO 

%

Territory 

%

State/

DC 

%

Up to 

10,000 

%

10,000 to 

75,000 

%

More than 

75,000 

%

Northwest 

%

Mid-Atlantic 

%

Southeast 

%

Midwest

%

Southwe

%

Q21PG_1 Pregnant: 1st (Most prevalent)

25.9 20.0 16.0 24.1 19.0 15.6 30.0 -- 44.4 -- 27.8 

110 -- -- 4.0 -- 4.8 3.1 -- 11.1 11.1 -- -- 111 33.3 60.0 58.0 34.5 66.7 53.1 50.0 44.4 44.4 80.0 33.3 131 -- -- 2.0 -- 4.8 -- -- -- -- -- -- 201 3.7 -- -- 3.4 -- -- -- -- -- -- -- 331 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 332 3.7 -- -- 3.4 -- -- 10.0 -- -- -- -- 401 7.4 -- 8.0 6.9 4.8 9.4 10.0 22.2 -- -- -- 427 18.5 20.0 10.0 20.7 -- 15.6 -- 11.1 -- 20.0 33.3 43 3.7 -- -- 3.4 -- -- -- -- -- -- -- CH -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 

Q21PG_2 Pregnant: 2nd

29.6 20.0 16.0 27.6 19.0 15.6 30.0 -- 44.4 -- 33.3 

101 -- -- 2.0 -- 4.8 -- -- -- -- -- -- 111 14.8 -- 14.0 13.8 9.5 15.6 20.0 11.1 -- -- 16.7 131 7.4 -- 16.0 3.4 19.0 15.6 20.0 22.2 -- 20.0 5.6 133 7.4 -- 2.0 6.9 4.8 -- 10.0 -- -- -- 11.1 17 3.7 -- -- 3.4 -- -- -- -- -- -- -- 201 7.4 40.0 2.0 13.8 4.8 -- -- -- -- -- 11.1 331 3.7 20.0 -- 6.9 -- -- -- 11.1 -- -- -- 332 11.1 -- 14.0 10.3 19.0 9.4 10.0 -- -- -- 5.6 360 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 371 3.7 -- 6.0 3.4 9.5 3.1 10.0 11.1 -- 20.0 -- 400 -- -- 4.0 -- -- 6.3 -- -- 22.2 -- -- 401 -- 20.0 8.0 -- 4.8 12.5 -- 22.2 -- 20.0 -- 427 7.4 -- 12.0 6.9 4.8 15.6 -- 11.1 33.3 20.0 11.1 904 -- -- 2.0 -- -- 3.1 -- -- -- 20.0 -- HW -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 

Q21PG_3 Pregnant: 3rd

29.6 20.0 16.0 27.6 19.0 15.6 30.0 -- 44.4 -- 33.3 

101 -- -- 2.0 -- 4.8 -- 10.0 -- -- -- -- 111 14.8 -- 2.0 13.8 -- 3.1 10.0 -- -- -- 5.6 131 -- 60.0 20.0 6.9 9.5 28.1 -- 44.4 11.1 40.0 5.6 132 11.1 -- 4.0 10.3 -- 6.3 10.0 -- -- -- 11.1 133 -- -- 2.0 -- 4.8 -- -- -- -- -- -- 201 7.4 -- 4.0 6.9 4.8 3.1 -- -- -- -- 5.6 321 3.7 -- 2.0 3.4 4.8 -- -- -- -- -- 5.6 332 18.5 -- 16.0 13.8 19.0 15.6 10.0 11.1 11.1 40.0 16.7 334 -- 20.0 2.0 3.4 -- 3.1 -- 11.1 -- -- -- 371 11.1 -- 6.0 10.3 4.8 6.3 -- -- 11.1 -- 11.1 401 -- -- 6.0 -- 9.5 3.1 10.0 11.1 -- -- -- 427 -- -- 12.0 -- 14.3 9.4 20.0 -- 11.1 20.0 -- 904 3.7 -- 4.0 3.4 4.8 3.1 -- 11.1 11.1 -- 5.6 CF -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 
 C-23 National Surv

Type of Organization Number of Participants Region

ITO 

%

Territory 

%

State/

DC 

%

Up to 

10,000 

%

10,000 to 

75,000 

%

More than 

75,000 

%

Northwest 

%

Mid-Atlantic 

%

Southeast 

%

Midwest

%

Southwe

%

Q21PG_4 Pregnant: 4th

29.6 20.0 16.0 27.6 19.0 15.6 30.0 -- 44.4 -- 33.3 

101 7.4 -- -- 6.9 -- -- -- -- -- -- -- 111 7.4 20.0 -- 10.3 -- -- -- 11.1 -- -- 5.6 131 11.1 -- -- 10.3 -- -- -- -- -- -- 11.1 132 3.7 20.0 4.0 3.4 4.8 6.3 10.0 11.1 -- -- -- 133 -- -- 8.0 -- 14.3 3.1 10.0 11.1 -- -- -- 201 14.8 -- 6.0 13.8 4.8 6.3 20.0 11.1 11.1 -- 11.1 303 -- -- 2.0 -- 4.8 -- -- -- -- -- -- 321 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 331 3.7 -- -- -- 4.8 -- -- -- -- -- -- 332 7.4 -- 16.0 6.9 9.5 18.8 10.0 -- 11.1 20.0 11.1 334 -- 20.0 8.0 3.4 9.5 6.3 -- 22.2 -- -- -- 370 -- -- 2.0 -- 4.8 -- 10.0 -- -- -- -- 371 3.7 -- 10.0 3.4 4.8 12.5 -- -- 11.1 20.0 11.1 401 3.7 -- 10.0 3.4 14.3 6.3 10.0 22.2 11.1 -- -- 427 -- 20.0 10.0 3.4 4.8 12.5 -- -- -- 40.0 5.6 904 3.7 -- 6.0 3.4 -- 9.4 -- -- 11.1 20.0 5.6 CA -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 

Q21PG_5 Pregnant: 5th

29.6 20.0 16.0 27.6 19.0 15.6 30.0 -- 44.4 -- 33.3 

101 -- -- 2.0 -- 4.8 -- -- -- -- -- -- 111 7.4 -- -- 6.9 -- -- 10.0 -- -- -- -- 131 -- -- 4.0 -- 4.8 3.1 10.0 -- -- -- -- 132 3.7 -- 10.0 3.4 -- 15.6 -- 11.1 22.2 -- 5.6 133 11.1 -- 4.0 6.9 4.8 6.3 -- -- -- -- 11.1 200 -- -- 2.0 -- 4.8 -- -- -- -- -- -- 201 3.7 20.0 12.0 6.9 14.3 9.4 10.0 44.4 22.2 -- 5.6 321 -- -- 2.0 -- 4.8 -- 10.0 -- -- -- -- 331 -- -- 2.0 -- 4.8 -- -- -- -- -- -- 332 11.1 40.0 6.0 17.2 4.8 6.3 -- 22.2 -- -- 5.6 334 -- -- 6.0 -- 4.8 6.3 -- -- 11.1 -- -- 337 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 345 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 355 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 371 7.4 -- 12.0 6.9 9.5 12.5 20.0 -- -- 20.0 5.6 401 -- -- 4.0 -- 4.8 3.1 -- -- -- -- -- 422 3.7 -- -- 3.4 -- -- 10.0 -- -- -- -- 427 7.4 -- 10.0 6.9 14.3 6.3 -- -- -- 40.0 5.6 503 -- 20.0 2.0 -- -- 6.3 -- 11.1 -- 20.0 -- 904 3.7 -- 4.0 3.4 -- 6.3 -- -- -- 20.0 11.1 AR -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 
 C-24 National Surv

Type of Organization Number of Participants Region

ITO 

%

Territory 

%

State/

DC 

%

Up to 

10,000 

%

10,000 to 

75,000 

%

More than 

75,000 

%

Northwest 

%

Mid-Atlantic 

%

Southeast 

%

Midwest

%

Southwe

%

Q21PG_6 Pregnant: 6th

33.3 20.0 16.0 31.0 19.0 15.6 30.0 -- 44.4 -- 38.9 

101 7.4 40.0 4.0 10.3 -- 9.4 20.0 11.1 -- -- 5.6 111 -- -- 2.0 -- 4.8 -- -- 11.1 -- -- -- 131 -- -- 4.0 -- 4.8 3.1 10.0 -- 11.1 -- -- 132 7.4 -- 10.0 3.4 23.8 3.1 10.0 11.1 -- -- 5.6 133 3.7 -- 2.0 3.4 4.8 -- 20.0 -- -- -- -- 201 3.7 -- 16.0 3.4 4.8 21.9 -- 11.1 11.1 20.0 5.6 312 -- 20.0 2.0 3.4 -- 3.1 -- 11.1 11.1 -- -- 321 -- -- 2.0 -- -- 3.1 -- -- -- -- 5.6 331 7.4 20.0 4.0 10.3 4.8 3.1 -- 11.1 -- -- -- 332 -- -- 4.0 -- 9.5 -- -- -- -- -- -- 334 11.1 -- 4.0 10.3 -- 6.3 -- -- -- 20.0 5.6 341 -- -- 4.0 -- -- 6.3 -- -- -- 20.0 5.6 371 3.7 -- 8.0 3.4 14.3 3.1 -- 11.1 -- 20.0 5.6 381 3.7 -- 2.0 3.4 4.8 -- -- -- -- -- 5.6 401 3.7 -- 2.0 3.4 -- 3.1 -- 11.1 -- -- 5.6 427 11.1 -- 8.0 10.3 4.8 9.4 10.0 -- 11.1 20.0 5.6 904 3.7 -- 4.0 3.4 -- 6.3 -- -- 11.1 -- 5.6 AA -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 

Q21PG_7 Pregnant: 7th (Least prevalent)

33.3 40.0 20.0 34.5 23.8 18.8 50.0 -- 44.4 20.0 33.3 

101 -- 20.0 6.0 3.4 -- 9.4 -- 11.1 11.1 -- 5.6 111 3.7 -- 2.0 3.4 -- 3.1 -- -- -- -- -- 131 -- -- 6.0 -- 9.5 3.1 -- -- -- -- -- 132 7.4 -- 4.0 6.9 -- 6.3 -- 11.1 -- -- -- 133 -- 20.0 4.0 -- -- 9.4 10.0 11.1 -- 20.0 -- 201 3.7 -- 6.0 3.4 4.8 6.3 -- -- -- 20.0 11.1 301 -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 303 3.7 -- -- 3.4 -- -- 10.0 -- -- -- -- 311 -- -- 6.0 -- 4.8 6.3 -- -- 11.1 20.0 -- 321 -- -- 2.0 -- 4.8 -- -- -- -- -- -- 331 3.7 -- 4.0 3.4 9.5 -- -- 11.1 -- -- 5.6 332 7.4 -- 6.0 6.9 -- 9.4 -- 11.1 -- 20.0 5.6 334 -- -- 2.0 -- -- 3.1 -- -- 11.1 -- -- 345 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 359 -- -- 2.0 -- -- 3.1 -- -- -- -- 5.6 371 14.8 -- 10.0 13.8 9.5 9.4 10.0 -- 22.2 -- 11.1 381 -- -- 6.0 -- 9.5 3.1 10.0 11.1 -- -- -- 401 7.4 -- 4.0 3.4 14.3 -- -- 11.1 -- -- -- 427 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 601 -- 20.0 -- 3.4 -- -- -- -- -- -- -- 82 -- -- 2.0 -- 4.8 -- -- -- -- -- -- 904 7.4 -- 4.0 6.9 4.8 3.1 10.0 -- -- -- 11.1 CC -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 
 C-25 National Surv

Type of Organization Number of Participants Region

ITO 

%

Territory 

%

State/

DC 

%

Up to 

10,000 

%

10,000 to 

75,000 

%

More than 

75,000 

%

Northwest 

%

Mid-Atlantic 

%

Southeast 

%

Midwest

%

Southwe

%

Q21BF_1 Breastfeeding: 1st (Most prevalent)

25.9 20.0 16.0 24.1 19.0 15.6 30.0 -- 44.4 -- 27.8 

110 -- -- 2.0 -- -- 3.1 -- -- 11.1 -- -- 111 11.1 40.0 36.0 13.8 47.6 28.1 40.0 55.6 -- 20.0 22.2 113 3.7 -- -- 3.4 -- -- -- -- -- -- -- 114 -- -- 2.0 -- -- 3.1 -- -- 11.1 -- -- 133 7.4 -- 4.0 6.9 4.8 3.1 10.0 -- -- 20.0 -- 201 -- -- 2.0 -- -- 3.1 10.0 -- -- -- -- 331 3.7 -- -- 3.4 -- -- -- -- -- -- -- 332 -- -- 2.0 -- 4.8 -- -- -- -- -- -- 401 7.4 -- 4.0 6.9 4.8 3.1 -- 22.2 -- -- -- 427 7.4 20.0 4.0 10.3 -- 6.3 -- 11.1 -- 20.0 11.1 601 29.6 20.0 26.0 27.6 19.0 31.3 10.0 -- 33.3 40.0 38.9 9 3.7 -- -- 3.4 -- -- -- -- -- -- -- CH -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 

Q21BF_2 Breastfeeding: 2nd

29.6 20.0 16.0 27.6 19.0 15.6 30.0 -- 44.4 -- 33.3 

101 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 111 25.9 20.0 30.0 24.1 28.6 31.3 30.0 11.1 22.2 60.0 22.2 133 3.7 40.0 26.0 6.9 28.6 25.0 10.0 44.4 11.1 20.0 5.6 201 7.4 20.0 4.0 10.3 4.8 3.1 10.0 11.1 11.1 -- 11.1 331 7.4 -- -- 6.9 -- -- -- -- -- -- 5.6 332 11.1 -- 4.0 10.3 4.8 3.1 10.0 -- -- -- -- 401 -- -- 6.0 -- 4.8 6.3 -- -- -- 20.0 -- 427 3.7 -- 8.0 3.4 4.8 9.4 10.0 -- 11.1 -- 11.1 601 7.4 -- 4.0 6.9 4.8 3.1 -- 22.2 -- -- 5.6 CF -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 

Q21BF_3 Breastfeeding: 3rd

33.3 20.0 16.0 31.0 19.0 15.6 40.0 -- 44.4 -- 33.3 

111 18.5 20.0 8.0 20.7 4.8 9.4 -- 22.2 11.1 -- 5.6 133 7.4 -- 16.0 6.9 14.3 15.6 20.0 11.1 11.1 20.0 11.1 201 11.1 60.0 22.0 17.2 19.0 25.0 10.0 33.3 11.1 20.0 11.1 332 3.7 -- 4.0 -- 9.5 3.1 -- -- -- 20.0 -- 341 -- -- 2.0 -- -- 3.1 -- -- -- -- 5.6 359 7.4 -- 2.0 6.9 4.8 -- -- -- -- -- 11.1 371 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 401 3.7 -- 4.0 3.4 4.8 3.1 20.0 -- -- -- -- 426 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 427 -- -- 10.0 -- 4.8 12.5 -- -- 11.1 20.0 5.6 601 3.7 -- 12.0 3.4 19.0 6.3 10.0 11.1 11.1 20.0 5.6 602 3.7 -- -- 3.4 -- -- -- -- -- -- -- 603 -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- AA -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 
 C-26 National Surv

Type of Organization Number of Participants Region

ITO 

%

Territory 

%

State/

DC 

%

Up to 

10,000 

%

10,000 to 

75,000 

%

More than 

75,000 

%

Northwest 

%

Mid-Atlantic 

%

Southeast 

%

Midwest

%

Southwe

%

Q21BF_4 Breastfeeding: 4th

37.0 20.0 16.0 34.5 19.0 15.6 40.0 -- 44.4 -- 38.9 

101 3.7 -- 2.0 3.4 4.8 -- -- -- -- -- -- 111 7.4 -- -- 6.9 -- -- -- -- -- -- -- 120 -- -- 2.0 -- 4.8 -- -- 11.1 -- -- -- 133 11.1 -- 6.0 10.3 4.8 6.3 10.0 -- -- -- 5.6 201 14.8 -- 20.0 10.3 23.8 18.8 20.0 11.1 33.3 -- 22.2 210 -- -- 2.0 -- 4.8 -- -- -- -- -- -- 312 -- 20.0 2.0 3.4 -- 3.1 -- 22.2 -- -- -- 331 -- -- 2.0 -- 4.8 -- -- -- -- -- -- 332 11.1 20.0 12.0 13.8 9.5 12.5 20.0 -- -- -- 11.1 341 -- -- 2.0 -- -- 3.1 -- -- -- 20.0 -- 359 -- -- 8.0 -- 4.8 9.4 -- 11.1 -- 20.0 -- 371 -- -- 2.0 -- 4.8 -- -- 11.1 -- -- -- 381 3.7 -- -- 3.4 -- -- -- -- -- -- -- 401 3.7 -- 4.0 3.4 4.8 3.1 -- 11.1 -- -- 5.6 427 7.4 20.0 8.0 10.3 4.8 9.4 10.0 -- 11.1 40.0 11.1 601 -- 20.0 8.0 -- 4.8 12.5 -- 11.1 11.1 -- 5.6 904 -- -- 2.0 -- -- 3.1 -- -- -- 20.0 -- HW -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 

Q21BF_5 Breastfeeding: 5th

37.0 20.0 16.0 34.5 19.0 15.6 40.0 -- 44.4 -- 38.9 

111 3.7 -- -- 3.4 -- -- -- -- -- -- -- 131 -- 20.0 -- 3.4 -- -- -- -- -- -- -- 133 3.7 -- 4.0 3.4 -- 6.3 -- -- 11.1 -- 5.6 200 -- -- 2.0 -- 4.8 -- -- -- -- -- -- 201 3.7 -- 16.0 3.4 14.3 15.6 10.0 11.1 -- 40.0 5.6 311 -- 20.0 2.0 3.4 4.8 -- -- -- -- -- -- 312 -- -- 2.0 -- 4.8 -- -- 11.1 -- -- -- 331 3.7 -- 2.0 -- 4.8 3.1 -- -- -- -- -- 332 3.7 -- 6.0 3.4 4.8 6.3 -- 11.1 -- -- 11.1 333 3.7 -- -- 3.4 -- -- -- -- -- -- -- 335 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 337 -- -- 4.0 -- 4.8 3.1 -- 11.1 -- -- -- 355 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 359 3.7 20.0 12.0 3.4 4.8 18.8 10.0 11.1 11.1 20.0 5.6 371 11.1 -- 6.0 10.3 9.5 3.1 20.0 -- -- 20.0 5.6 381 -- -- 2.0 -- 4.8 -- 10.0 -- -- -- -- 400 -- -- 4.0 -- -- 6.3 -- -- 22.2 -- -- 401 3.7 -- 4.0 3.4 4.8 3.1 -- 11.1 -- -- -- 427 3.7 -- 8.0 3.4 9.5 6.3 -- -- -- 20.0 5.6 601 3.7 20.0 4.0 6.9 4.8 3.1 10.0 22.2 -- -- -- 602 3.7 -- -- 3.4 -- -- -- -- -- -- -- 904 3.7 -- 4.0 3.4 -- 6.3 -- -- 11.1 -- 11.1 BT -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 
 C-27 National Surv

Type of Organization Number of Participants Region

ITO 

%

Territory 

%

State/

DC 

%

Up to 

10,000 

%

10,000 to 

75,000 

%

More than 

75,000 

%

Northwest 

%

Mid-Atlantic 

%

Southeast 

%

Midwest

%

Southwe

%

Q21BF_6 Breastfeeding: 6th

40.7 20.0 16.0 37.9 19.0 15.6 50.0 -- 44.4 -- 38.9 

101 3.7 20.0 -- 3.4 -- 3.1 -- 11.1 -- -- -- 111 3.7 -- 2.0 3.4 -- 3.1 -- -- -- -- 5.6 113 -- -- 2.0 -- -- 3.1 -- -- -- -- 5.6 132 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 133 7.4 -- 2.0 6.9 -- 3.1 -- -- 11.1 -- -- 201 -- -- 4.0 -- 4.8 3.1 -- 11.1 -- -- -- 210 -- -- 2.0 -- 4.8 -- 10.0 -- -- -- -- 303 -- -- 2.0 -- 4.8 -- -- -- -- -- -- 311 -- -- 2.0 -- -- 3.1 -- -- -- 20.0 -- 312 7.4 -- -- 6.9 -- -- -- -- -- -- 11.1 331 -- -- 4.0 -- 4.8 3.1 -- 11.1 11.1 -- -- 332 3.7 -- 10.0 3.4 -- 15.6 -- 11.1 22.2 40.0 5.6 334 -- 20.0 -- 3.4 -- -- -- -- -- -- -- 337 -- 20.0 -- 3.4 -- -- -- -- -- -- -- 355 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 359 3.7 -- 10.0 -- 9.5 12.5 10.0 11.1 -- 20.0 5.6 360 -- 20.0 -- 3.4 -- -- -- 11.1 -- -- -- 371 14.8 -- 12.0 13.8 19.0 6.3 10.0 -- -- -- 11.1 401 -- -- 16.0 -- 19.0 12.5 -- 22.2 11.1 -- -- 427 3.7 -- 4.0 3.4 4.8 3.1 10.0 -- -- 20.0 -- 601 -- -- 6.0 -- 9.5 3.1 10.0 -- -- -- -- 602 3.7 -- 2.0 3.4 -- 3.1 -- -- -- -- 5.6 904 -- -- 2.0 -- -- 3.1 -- -- -- -- -- AR -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 

Q21BF_7 Breastfeeding: 7th (Least prevalent)

40.7 60.0 22.0 44.8 23.8 21.9 60.0 -- 55.6 20.0 38.9 

101 -- -- 2.0 -- 4.8 -- -- -- -- -- -- 111 3.7 -- -- 3.4 -- -- -- -- -- -- -- 201 18.5 -- 4.0 17.2 -- 6.3 -- -- 11.1 -- 11.1 303 -- -- 2.0 -- -- 3.1 -- -- -- -- -- 311 -- -- 2.0 -- 4.8 -- 10.0 -- -- -- -- 321 -- -- 2.0 -- 4.8 -- -- -- -- -- -- 331 7.4 -- 6.0 6.9 9.5 3.1 -- 22.2 -- -- 5.6 332 3.7 -- 12.0 3.4 9.5 12.5 10.0 11.1 -- -- -- 334 3.7 -- -- 3.4 -- -- -- -- -- -- -- 337 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 359 7.4 -- 8.0 6.9 9.5 6.3 -- -- 11.1 -- 16.7 371 -- -- 10.0 -- 9.5 9.4 10.0 -- -- 20.0 -- 401 -- 20.0 8.0 -- -- 15.6 -- 11.1 -- 40.0 5.6 427 3.7 -- 6.0 3.4 -- 9.4 -- 11.1 11.1 -- 5.6 502 -- -- 2.0 -- 4.8 -- -- -- -- -- -- 600 -- -- 2.0 -- -- 3.1 -- -- 11.1 -- -- 601 -- 20.0 6.0 3.4 9.5 3.1 10.0 22.2 -- 20.0 -- 602 3.7 -- 2.0 -- 4.8 3.1 -- -- -- -- 5.6 904 3.7 -- 2.0 3.4 4.8 -- -- 11.1 -- -- 5.6 BC -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 
 C-28 National Surv

Type of Organization Number of Participants Region

ITO 

%

Territory 

%

State/

DC 

%

Up to 

10,000 

%

10,000 to 

75,000 

%

More than 

75,000 

%

Northwest 

%

Mid-Atlantic 

%

Southeast 

%

Midwest

%

Southwe

%

Q21PP_1 Postpartum: 1st (Most prevalent)

25.9 20.0 16.0 24.1 19.0 15.6 30.0 -- 44.4 -- 27.8 

110 -- -- 2.0 -- -- 3.1 -- -- 11.1 -- -- 111 25.9 60.0 54.0 27.6 66.7 46.9 50.0 44.4 22.2 60.0 33.3 113 3.7 -- -- 3.4 -- -- -- -- -- -- -- 114 -- -- 2.0 -- -- 3.1 -- -- 11.1 -- -- 133 3.7 -- 4.0 3.4 4.8 3.1 -- -- -- 20.0 5.6 201 3.7 -- 4.0 3.4 -- 6.3 10.0 11.1 -- -- -- 331 3.7 -- -- 3.4 -- -- 10.0 -- -- -- -- 371 -- -- 4.0 -- 9.5 -- -- 11.1 -- -- -- 401 11.1 -- 6.0 10.3 -- 9.4 -- 11.1 -- 20.0 5.6 427 18.5 20.0 6.0 20.7 -- 9.4 -- 11.1 11.1 -- 27.8 7 3.7 -- -- 3.4 -- -- -- -- -- -- -- CH -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 

Q21PP_2 Postpartum: 2nd

33.3 20.0 16.0 31.0 19.0 15.6 30.0 -- 44.4 -- 38.9 

111 18.5 -- 16.0 17.2 9.5 18.8 10.0 22.2 11.1 20.0 16.7 113 -- -- 2.0 -- -- 3.1 -- -- 11.1 -- -- 133 3.7 -- 32.0 3.4 28.6 31.3 20.0 22.2 11.1 20.0 11.1 201 14.8 40.0 16.0 17.2 23.8 12.5 30.0 33.3 11.1 20.0 5.6 332 11.1 20.0 2.0 10.3 9.5 -- -- -- -- -- -- 355 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 359 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 401 3.7 -- 4.0 3.4 4.8 3.1 10.0 11.1 -- -- -- 427 7.4 20.0 10.0 10.3 4.8 12.5 -- -- 11.1 40.0 16.7 CF -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 

Q21PP_3 Postpartum: 3rd

37.0 40.0 16.0 37.9 19.0 15.6 40.0 11.1 44.4 -- 38.9 

101 3.7 -- -- 3.4 -- -- -- -- -- -- -- 111 14.8 -- 2.0 13.8 -- 3.1 -- -- -- -- 5.6 133 11.1 40.0 6.0 13.8 4.8 9.4 20.0 22.2 -- 20.0 -- 201 7.4 -- 30.0 3.4 33.3 28.1 -- 33.3 22.2 20.0 22.2 332 11.1 -- 14.0 10.3 14.3 12.5 -- -- -- -- 16.7 359 7.4 -- -- 6.9 -- -- -- -- -- -- 11.1 371 7.4 -- 6.0 6.9 9.5 3.1 10.0 -- -- 20.0 5.6 400 -- -- 2.0 -- -- 3.1 -- -- 11.1 -- -- 401 -- -- 10.0 -- 14.3 6.3 20.0 22.2 -- -- -- 427 -- -- 8.0 -- 4.8 9.4 10.0 -- 11.1 20.0 -- 601 -- 20.0 -- 3.4 -- -- -- -- -- -- -- 904 -- -- 4.0 -- -- 6.3 -- -- 11.1 20.0 -- AA -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 
 C-29 National Surv

Type of Organization Number of Participants Region

ITO 

%

Territory 

%

State/

DC 

%

Up to 

10,000 

%

10,000 to 

75,000 

%

More than 

75,000 

%

Northwest 

%

Mid-Atlantic 

%

Southeast 

%

Midwest

%

Southwe

%

Q21PP_4 Postpartum: 4th

37.0 20.0 16.0 34.5 19.0 15.6 40.0 -- 44.4 -- 38.9 

101 -- -- 4.0 -- 9.5 -- 10.0 -- -- -- -- 111 3.7 20.0 -- 6.9 -- -- -- 11.1 -- -- -- 133 3.7 -- 10.0 3.4 14.3 6.3 10.0 11.1 -- -- -- 201 14.8 40.0 14.0 20.7 19.0 9.4 20.0 -- 22.2 20.0 5.6 312 3.7 -- 2.0 3.4 -- 3.1 -- 11.1 -- -- 5.6 331 11.1 -- 4.0 6.9 9.5 3.1 10.0 -- -- -- 5.6 332 11.1 -- 10.0 10.3 9.5 9.4 10.0 11.1 11.1 20.0 11.1 341 -- -- 4.0 -- -- 6.3 -- -- -- 20.0 5.6 359 3.7 20.0 12.0 3.4 4.8 18.8 -- 22.2 11.1 20.0 5.6 371 7.4 -- 2.0 6.9 -- 3.1 -- -- -- -- 5.6 372 -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 401 -- -- 4.0 -- 4.8 3.1 -- -- -- -- -- 427 -- -- 10.0 -- 4.8 12.5 -- -- 11.1 20.0 5.6 904 3.7 -- 4.0 3.4 4.8 3.1 -- 11.1 -- -- 11.1 BT -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 

Q21PP_5 Postpartum: 5th

37.0 20.0 16.0 34.5 19.0 15.6 40.0 -- 44.4 -- 38.9 

101 -- 20.0 -- -- -- 3.1 -- 11.1 -- -- -- 111 3.7 -- 4.0 3.4 4.8 3.1 10.0 11.1 -- -- -- 133 11.1 -- 2.0 10.3 -- 3.1 -- -- 11.1 -- 11.1 201 7.4 -- 6.0 6.9 -- 9.4 -- -- -- -- 11.1 303 3.7 -- 2.0 3.4 4.8 -- -- -- -- -- -- 312 -- 20.0 2.0 3.4 4.8 -- -- 22.2 -- -- -- 321 -- -- 2.0 -- -- 3.1 -- -- -- 20.0 -- 331 3.7 -- 2.0 3.4 4.8 -- 10.0 -- -- -- 5.6 332 3.7 -- 16.0 3.4 9.5 18.8 -- 11.1 22.2 20.0 -- 355 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 359 -- -- 14.0 -- 9.5 15.6 10.0 11.1 -- 20.0 11.1 371 7.4 -- 16.0 6.9 19.0 12.5 10.0 11.1 -- 20.0 5.6 372 -- -- 2.0 -- -- 3.1 -- -- 11.1 -- -- 401 3.7 20.0 6.0 3.4 14.3 3.1 10.0 11.1 -- -- -- 410 -- -- 2.0 -- 4.8 -- 10.0 -- -- -- -- 427 7.4 -- 2.0 6.9 -- 3.1 -- -- -- 20.0 5.6 502 -- -- 2.0 -- 4.8 -- -- -- -- -- -- 602 3.7 20.0 -- 6.9 -- -- -- -- -- -- -- 902 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 904 -- -- 2.0 -- -- 3.1 -- -- 11.1 -- -- HW -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 
 C-30 National Surv

Type of Organization Number of Participants Region

ITO 

%

Territory 

%

State/

DC 

%

Up to 

10,000 

%

10,000 to 

75,000 

%

More than 

75,000 

%

Northwest 

%

Mid-Atlantic 

%

Southeast 

%

Midwest

%

Southwe

%

Q21PP_6 Postpartum: 6th

51.9 20.0 16.0 48.3 19.0 15.6 50.0 -- 44.4 -- 44.4 

101 -- -- 2.0 -- 4.8 -- -- -- -- -- -- 111 7.4 -- -- 6.9 -- -- -- -- -- -- -- 132 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 133 -- 20.0 -- 3.4 -- -- -- -- -- -- -- 201 -- -- 6.0 -- -- 9.4 -- -- -- 20.0 -- 311 -- -- 4.0 -- 4.8 3.1 -- -- 11.1 -- -- 321 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 331 3.7 -- 14.0 3.4 14.3 12.5 -- 22.2 22.2 -- 5.6 332 3.7 -- 16.0 3.4 14.3 15.6 20.0 11.1 -- 20.0 11.1 337 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 357 -- -- 2.0 -- -- 3.1 -- -- 11.1 -- -- 359 3.7 -- 10.0 -- 14.3 9.4 -- -- 11.1 -- -- 361 3.7 -- -- 3.4 -- -- -- -- -- -- -- 371 3.7 -- 6.0 3.4 -- 9.4 -- -- -- 20.0 11.1 381 -- -- 2.0 -- 4.8 -- 10.0 -- -- -- -- 401 3.7 40.0 4.0 6.9 9.5 3.1 -- 44.4 -- -- -- 427 -- -- 12.0 -- 14.3 9.4 20.0 11.1 -- 40.0 -- 601 -- -- 2.0 -- -- 3.1 -- -- -- -- -- 902 -- 20.0 -- 3.4 -- -- -- -- -- -- -- 904 7.4 -- 2.0 6.9 -- 3.1 -- -- -- -- 11.1 AR -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 

Q21PP_7 Postpartum: 7th (Least prevalent)

44.4 40.0 20.0 44.8 23.8 18.8 60.0 -- 44.4 20.0 33.3 

101 -- 20.0 2.0 3.4 4.8 -- -- 11.1 -- -- -- 201 7.4 -- 2.0 6.9 -- 3.1 -- 11.1 -- -- 11.1 301 -- -- 2.0 -- -- 3.1 -- -- 11.1 -- -- 311 3.7 -- 12.0 -- 14.3 12.5 10.0 -- -- 40.0 5.6 312 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 321 -- -- 2.0 -- 4.8 -- -- -- -- -- -- 331 7.4 20.0 2.0 6.9 -- 6.3 -- 11.1 -- -- -- 332 -- -- 2.0 -- -- 3.1 -- -- -- -- 5.6 334 -- 20.0 -- 3.4 -- -- -- -- -- -- -- 337 -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 359 7.4 -- 10.0 6.9 14.3 6.3 10.0 11.1 11.1 20.0 11.1 371 7.4 -- 16.0 6.9 9.5 18.8 10.0 11.1 22.2 -- 5.6 381 3.7 -- 2.0 3.4 4.8 -- -- -- -- -- -- 401 -- -- 8.0 -- 4.8 9.4 10.0 -- -- -- -- 427 7.4 -- 8.0 6.9 9.5 6.3 -- 11.1 11.1 -- 5.6 502 -- -- 2.0 -- 4.8 -- -- -- -- -- -- 901 -- -- 2.0 -- -- 3.1 -- -- -- -- 5.6 904 7.4 -- 4.0 6.9 4.8 3.1 -- 11.1 -- 20.0 11.1 BC -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 
 C-31 National Surv

Type of Organization Number of Participants Region

ITO 

%

Territory 

%

State/

DC 

%

Up to 

10,000 

%

10,000 to 

75,000 

%

More than 

75,000 

%

Northwest 

%

Mid-Atlantic 

%

Southeast 

%

Midwest

%

Southwe

%

Q21IN_1 Infants: 1st (Most prevalent)

29.6 20.0 16.0 27.6 19.0 15.6 40.0 -- 44.4 -- 27.8 

103 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 114 3.7 -- -- 3.4 -- -- 10.0 -- -- -- -- 121 -- -- 2.0 -- 4.8 -- -- -- -- -- -- 411 3.7 40.0 6.0 10.3 -- 9.4 -- 22.2 -- 20.0 -- 428 3.7 -- -- 3.4 -- -- -- -- -- -- -- 701 48.1 40.0 70.0 44.8 76.2 65.6 50.0 66.7 44.4 80.0 61.1 702 3.7 -- 2.0 3.4 -- 3.1 -- -- -- -- 5.6 710 -- -- 2.0 -- -- 3.1 -- -- 11.1 -- -- 801 3.7 -- -- 3.4 -- -- -- -- -- -- -- FP -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 

Q21IN_2 Infants: 2nd

33.3 20.0 16.0 31.0 19.0 15.6 40.0 -- 44.4 -- 33.3 

103 -- -- 6.0 -- 14.3 -- 10.0 11.1 -- -- -- 111 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 114 -- 20.0 4.0 3.4 4.8 3.1 -- 11.1 11.1 -- -- 121 -- 20.0 6.0 -- 4.8 9.4 -- 11.1 -- 20.0 -- 141 3.7 -- 2.0 3.4 4.8 -- -- -- -- -- -- 142 -- -- 4.0 -- -- 6.3 -- 11.1 -- -- 5.6 355 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 411 14.8 -- 18.0 13.8 14.3 18.8 -- 11.1 -- 20.0 11.1 412 -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 425 -- -- 2.0 -- -- 3.1 -- -- -- -- 5.6 428 -- -- 2.0 -- -- 3.1 -- -- -- 20.0 -- 601 -- -- 2.0 -- -- 3.1 -- -- -- 20.0 -- 603 3.7 -- -- 3.4 -- -- -- -- -- -- -- 700 -- -- 2.0 -- -- 3.1 -- -- 11.1 -- -- 701 14.8 20.0 4.0 17.2 -- 6.3 10.0 11.1 -- -- 5.6 702 22.2 20.0 18.0 20.7 28.6 12.5 30.0 -- 11.1 -- 27.8 711 -- -- 2.0 -- -- 3.1 -- -- 11.1 -- -- 904 -- -- 8.0 -- 9.5 6.3 10.0 11.1 11.1 20.0 -- DM -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 
 C-32 National Surv

Type of Organization Number of Participants Region

ITO 

%

Territory 

%

State/

DC 

%

Up to 

10,000 

%

10,000 to 

75,000 

%

More than 

75,000 

%

Northwest 

%

Mid-Atlantic 

%

Southeast 

%

Midwest

%

Southwe

%

Q21IN_3 Infants: 3rd

37.0 20.0 16.0 34.5 19.0 15.6 40.0 -- 44.4 -- 38.9 

103 18.5 -- 4.0 17.2 9.5 -- 10.0 11.1 -- -- 16.7 113 -- 20.0 -- -- -- 3.1 -- 11.1 -- -- -- 114 3.7 -- 4.0 3.4 4.8 3.1 10.0 -- 11.1 -- -- 121 -- -- 8.0 -- 9.5 6.3 -- 11.1 22.2 -- -- 135 -- -- 2.0 -- 4.8 -- -- -- -- -- -- 141 3.7 20.0 2.0 6.9 -- 3.1 -- 11.1 -- -- 5.6 142 3.7 -- 10.0 -- 9.5 12.5 -- -- -- 40.0 5.6 152 3.7 -- -- 3.4 -- -- -- -- -- -- -- 201 3.7 -- 2.0 3.4 -- 3.1 -- -- 11.1 -- 5.6 311 -- -- 2.0 -- -- 3.1 10.0 -- -- -- -- 342 -- -- 2.0 -- 4.8 -- -- -- -- -- -- 355 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 400 -- -- 2.0 -- -- 3.1 -- -- 11.1 -- -- 401 3.7 -- -- 3.4 -- -- -- -- -- -- -- 411 11.1 20.0 26.0 13.8 14.3 31.3 20.0 -- -- 60.0 16.7 701 3.7 -- 2.0 3.4 4.8 -- -- -- -- -- -- 702 -- 20.0 16.0 3.4 19.0 12.5 10.0 44.4 -- -- -- 904 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 DE -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 

Q21IN_4 Infants: 4th

37.0 40.0 16.0 37.9 19.0 15.6 50.0 11.1 44.4 -- 33.3 

103 7.4 -- 4.0 6.9 -- 6.3 10.0 -- -- 20.0 5.6 114 11.1 -- 4.0 10.3 4.8 3.1 10.0 -- -- 20.0 11.1 121 11.1 -- 18.0 10.3 19.0 15.6 10.0 11.1 11.1 -- 5.6 141 3.7 -- 10.0 3.4 9.5 9.4 -- 11.1 -- -- 11.1 142 7.4 -- 10.0 6.9 14.3 6.3 10.0 11.1 11.1 -- 11.1 152 -- -- 2.0 -- 4.8 -- -- -- -- -- -- 153 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 201 3.7 -- -- 3.4 -- -- -- -- -- -- -- 342 -- 20.0 -- -- -- 3.1 -- 11.1 -- -- -- 400 -- -- 2.0 -- -- 3.1 -- -- 11.1 -- -- 411 7.4 20.0 10.0 6.9 14.3 9.4 -- -- -- 20.0 -- 41B -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 428 -- -- 2.0 -- 4.8 -- 10.0 -- -- -- -- 603 -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 700 -- -- 2.0 -- 4.8 -- -- -- -- -- -- 701 -- 20.0 2.0 3.4 4.8 -- -- 11.1 -- -- -- 702 -- -- 8.0 -- -- 12.5 -- -- 22.2 40.0 -- 904 7.4 -- 4.0 6.9 -- 6.3 -- -- -- -- 16.7 HI -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 
 C-33 National Surv

Type of Organization Number of Participants Region

ITO 

%

Territory 

%

State/

DC 

%

Up to 

10,000 

%

10,000 to 

75,000 

%

More than 

75,000 

%

Northwest 

%

Mid-Atlantic 

%

Southeast 

%

Midwest

%

Southwe

%

Q21IN_5 Infants: 5th

37.0 20.0 16.0 34.5 19.0 15.6 50.0 -- 44.4 -- 33.3 

103 -- 40.0 10.0 3.4 14.3 9.4 10.0 33.3 -- -- 5.6 114 3.7 -- -- 3.4 -- -- -- -- -- -- -- 121 14.8 20.0 16.0 13.8 19.0 15.6 20.0 11.1 -- 20.0 11.1 135 -- -- 2.0 -- -- 3.1 -- -- -- -- -- 141 18.5 -- 6.0 17.2 -- 9.4 -- 11.1 22.2 -- 16.7 142 7.4 -- 24.0 6.9 14.3 28.1 10.0 22.2 22.2 20.0 11.1 151 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 152 3.7 -- -- 3.4 -- -- -- -- -- -- -- 342 -- -- 2.0 -- -- 3.1 -- -- 11.1 -- -- 355 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 360 -- -- 2.0 -- 4.8 -- -- -- -- -- -- 411 -- -- 10.0 -- 14.3 6.3 10.0 -- -- 40.0 -- 428 3.7 -- 2.0 3.4 4.8 -- -- -- -- -- -- 603 -- 20.0 -- 3.4 -- -- -- -- -- -- -- 701 -- -- 4.0 -- 4.8 3.1 -- 11.1 -- -- 5.6 702 3.7 -- 2.0 3.4 4.8 -- -- -- -- -- 5.6 904 -- -- 2.0 -- -- 3.1 -- -- -- 20.0 -- DK -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 

Q21IN_6 Infants: 6th

40.7 20.0 16.0 37.9 19.0 15.6 50.0 -- 44.4 -- 38.9 

103 3.7 -- 2.0 3.4 -- 3.1 -- -- -- 20.0 -- 111 -- -- 2.0 -- -- 3.1 10.0 -- -- -- -- 114 11.1 -- 4.0 10.3 -- 6.3 -- -- -- 20.0 11.1 121 3.7 -- 10.0 3.4 14.3 6.3 -- 22.2 -- -- 5.6 135 -- -- 4.0 -- 4.8 3.1 10.0 11.1 -- -- -- 141 7.4 20.0 16.0 3.4 28.6 12.5 20.0 33.3 11.1 -- -- 142 3.7 -- 12.0 3.4 9.5 12.5 -- -- 22.2 -- -- 151 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 153 -- -- 4.0 -- 4.8 3.1 -- -- -- -- -- 337 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 353 -- -- 2.0 -- 4.8 -- -- -- -- -- -- 355 7.4 -- -- 6.9 -- -- -- -- -- -- 5.6 381 3.7 -- -- 3.4 -- -- -- -- -- -- -- 401 -- -- 2.0 -- -- 3.1 -- -- -- -- -- 411 3.7 20.0 6.0 6.9 -- 9.4 -- -- 22.2 20.0 5.6 413 -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 428 -- -- 4.0 -- 9.5 -- 10.0 -- -- -- -- 502 -- -- 2.0 -- 4.8 -- -- -- -- -- -- 603 3.7 20.0 -- 6.9 -- -- -- 11.1 -- -- 5.6 701 -- -- 2.0 -- -- 3.1 -- -- -- 20.0 -- 702 -- -- 2.0 -- -- 3.1 -- -- -- -- 5.6 902 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 904 -- 20.0 6.0 3.4 -- 9.4 -- -- -- 20.0 5.6 DC -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 
 C-34 National Surv

Type of Organization Number of Participants Region

ITO 

%

Territory 

%

State/

DC 

%

Up to 

10,000 

%

10,000 to 

75,000 

%

More than 

75,000 

%

Northwest 

%

Mid-Atlantic 

%

Southeast 

%

Midwest

%

Southwe

%

Q21IN_7 Infants: 7th (Least prevalent)

44.4 40.0 18.0 44.8 23.8 15.6 60.0 -- 44.4 -- 44.4 

103 11.1 -- 16.0 6.9 19.0 15.6 20.0 22.2 33.3 -- -- 114 -- -- 2.0 -- 4.8 -- -- 11.1 -- -- -- 121 11.1 20.0 6.0 13.8 4.8 6.3 -- 22.2 -- -- 11.1 135 -- 20.0 2.0 -- 4.8 3.1 -- 22.2 -- -- -- 141 -- -- 18.0 -- 4.8 25.0 10.0 -- 11.1 40.0 -- 153 7.4 -- 6.0 6.9 9.5 3.1 -- -- -- -- 11.1 201 -- -- 4.0 -- -- 6.3 -- 11.1 -- -- 5.6 342 -- -- 2.0 -- 4.8 -- -- -- -- -- -- 359 -- -- 2.0 -- 4.8 -- -- -- -- -- -- 371 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 411 3.7 20.0 4.0 6.9 4.8 3.1 -- -- -- 20.0 5.6 428 -- -- 2.0 -- -- 3.1 -- -- -- -- -- 601 -- -- 2.0 -- -- 3.1 -- -- -- 20.0 -- 602 -- -- 2.0 -- -- 3.1 -- -- -- -- -- 603 3.7 -- 4.0 3.4 4.8 3.1 -- -- -- 20.0 -- 701 3.7 -- -- 3.4 -- -- -- -- -- -- -- 702 -- -- 4.0 -- 4.8 3.1 10.0 -- 11.1 -- -- 904 11.1 -- 4.0 10.3 4.8 3.1 -- -- -- -- 16.7 CD -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 

Q21CH_1 Children: 1st (Most prevalent)

25.9 20.0 16.0 24.1 19.0 15.6 30.0 -- 44.4 -- 27.8 

113 3.7 20.0 2.0 3.4 4.8 3.1 -- 22.2 -- -- 5.6 114 11.1 -- 4.0 10.3 4.8 3.1 10.0 -- -- 20.0 5.6 121 -- -- 2.0 -- 4.8 -- -- -- -- -- -- 201 3.7 -- 2.0 3.4 -- 3.1 -- 11.1 -- -- -- 381 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 400 -- -- 2.0 -- -- 3.1 -- -- 11.1 -- -- 401 7.4 -- 14.0 6.9 19.0 9.4 20.0 11.1 -- -- 5.6 425 40.7 40.0 52.0 41.4 42.9 56.3 30.0 44.4 44.4 60.0 50.0 427 -- 20.0 -- 3.4 -- -- -- -- -- -- -- 801 3.7 -- -- 3.4 -- -- -- -- -- -- -- 904 -- -- 4.0 -- 4.8 3.1 10.0 -- -- 20.0 -- HC -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 
 C-35 National Surv

Type of Organization Number of Participants Region

ITO 

%

Territory 

%

State/

DC 

%

Up to 

10,000 

%

10,000 to 

75,000 

%

More than 

75,000 

%

Northwest 

%

Mid-Atlantic 

%

Southeast 

%

Midwest

%

Southwe

%

Q21CH_2 Children: 2nd

29.6 40.0 16.0 31.0 19.0 15.6 30.0 11.1 44.4 -- 33.3 

103 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 113 7.4 20.0 6.0 6.9 14.3 3.1 10.0 -- -- 20.0 -- 114 18.5 -- 10.0 17.2 4.8 12.5 10.0 11.1 11.1 20.0 11.1 135 -- 20.0 2.0 -- -- 6.3 -- 22.2 -- -- -- 201 14.8 -- 8.0 13.8 4.8 9.4 10.0 22.2 11.1 -- 22.2 400 -- -- 2.0 -- -- 3.1 -- -- 11.1 -- -- 401 7.4 -- 14.0 6.9 19.0 9.4 10.0 -- -- -- 5.6 411 -- -- 2.0 -- 4.8 -- -- -- -- -- -- 419 -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 425 11.1 20.0 30.0 13.8 28.6 28.1 30.0 -- 11.1 60.0 5.6 701 -- -- 2.0 -- -- 3.1 -- -- -- -- 5.6 702 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 904 3.7 -- 4.0 3.4 4.8 3.1 -- 11.1 11.1 -- 5.6 AA -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 

Q21CH_3 Children: 3rd

29.6 20.0 16.0 27.6 19.0 15.6 30.0 -- 44.4 -- 33.3 

103 3.7 20.0 2.0 6.9 4.8 -- 10.0 11.1 -- -- -- 111 -- -- 8.0 -- -- 12.5 10.0 22.2 -- -- -- 113 14.8 -- 8.0 13.8 9.5 6.3 20.0 11.1 -- -- 11.1 114 18.5 20.0 16.0 13.8 19.0 18.8 10.0 22.2 11.1 20.0 5.6 121 -- -- 2.0 -- 4.8 -- -- -- -- -- -- 135 -- -- 2.0 -- 4.8 -- 10.0 -- -- -- -- 141 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 201 3.7 20.0 8.0 6.9 9.5 6.3 -- -- -- -- 5.6 381 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 401 -- -- 10.0 -- 9.5 9.4 10.0 -- 22.2 -- 5.6 425 11.1 20.0 20.0 13.8 19.0 18.8 -- 22.2 11.1 60.0 11.1 428 3.7 -- -- 3.4 -- -- -- -- -- -- -- 701 -- -- 2.0 -- -- 3.1 -- -- -- -- 5.6 904 7.4 -- 4.0 6.9 -- 6.3 -- -- 11.1 20.0 11.1 HP -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 
 C-36 National Surv

Type of Organization Number of Participants Region

ITO 

%

Territory 

%

State/

DC 

%

Up to 

10,000 

%

10,000 to 

75,000 

%

More than 

75,000 

%

Northwest 

%

Mid-Atlantic 

%

Southeast 

%

Midwest

%

Southwe

%

Q21CH_4 Children: 4th

29.6 20.0 16.0 27.6 19.0 15.6 30.0 -- 44.4 -- 33.3 

102 3.7 -- -- 3.4 -- -- -- -- -- -- -- 103 3.7 40.0 -- 6.9 -- 3.1 10.0 11.1 -- -- -- 113 18.5 -- 16.0 17.2 14.3 15.6 10.0 -- -- 20.0 11.1 114 -- -- 10.0 -- 4.8 12.5 10.0 11.1 11.1 -- 5.6 121 11.1 -- 8.0 10.3 9.5 6.3 10.0 22.2 11.1 -- 11.1 135 -- 20.0 -- 3.4 -- -- -- 11.1 -- -- -- 201 22.2 -- 22.0 17.2 28.6 18.8 20.0 -- 22.2 20.0 22.2 355 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 401 -- -- 12.0 -- 14.3 9.4 -- 33.3 -- 40.0 -- 411 -- -- 2.0 -- 4.8 -- 10.0 -- -- -- -- 425 -- 20.0 8.0 3.4 4.8 9.4 -- -- 11.1 20.0 -- 501 3.7 -- -- 3.4 -- -- -- -- -- -- -- 701 -- -- 2.0 -- -- 3.1 -- -- -- -- -- 801 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 904 -- -- 2.0 -- -- 3.1 -- -- -- -- 5.6 DG -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 

Q21CH_5 Children: 5th

29.6 20.0 18.0 27.6 19.0 18.8 30.0 -- 55.6 -- 33.3 

103 7.4 -- 2.0 6.9 4.8 -- -- -- -- -- 11.1 110 -- -- 2.0 -- -- 3.1 -- -- 11.1 -- -- 113 7.4 20.0 4.0 10.3 4.8 3.1 20.0 11.1 -- -- 5.6 114 3.7 -- 8.0 3.4 9.5 6.3 20.0 -- 11.1 -- 5.6 121 7.4 40.0 8.0 10.3 9.5 9.4 -- 11.1 11.1 -- 5.6 130 -- -- 2.0 -- 4.8 -- -- 11.1 -- -- -- 135 -- -- 6.0 -- 9.5 3.1 -- 22.2 -- -- -- 201 7.4 -- 14.0 6.9 9.5 15.6 10.0 -- 11.1 40.0 5.6 353 -- 20.0 -- 3.4 -- -- -- -- -- -- -- 381 7.4 -- -- 3.4 4.8 -- -- -- -- -- 5.6 401 -- -- 10.0 -- -- 15.6 -- 22.2 -- 20.0 -- 411 -- -- 2.0 -- 4.8 -- -- -- -- -- -- 425 14.8 -- 8.0 13.8 9.5 6.3 -- 11.1 -- 40.0 -- 428 3.7 -- 8.0 3.4 9.5 6.3 10.0 -- -- -- 11.1 502 3.7 -- 2.0 3.4 -- 3.1 10.0 -- -- -- 5.6 701 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 903 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 904 -- -- 4.0 -- -- 6.3 -- -- -- -- -- DM -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 
 C-37 National Surv

Type of Organization Number of Participants Region

ITO 

%

Territory 

%

State/

DC 

%

Up to 

10,000 

%

10,000 to 

75,000 

%

More than 

75,000 

%

Northwest 

%

Mid-Atlantic 

%

Southeast 

%

Midwest

%

Southwe

%

Q21CH_6 Children: 6th

33.3 20.0 16.0 31.0 19.0 15.6 30.0 -- 44.4 -- 38.9 

103 -- -- 4.0 -- 9.5 -- 10.0 -- -- -- -- 113 11.1 -- 12.0 10.3 14.3 9.4 -- 11.1 22.2 -- 11.1 114 3.7 20.0 10.0 6.9 14.3 6.3 -- 22.2 -- 40.0 5.6 121 7.4 -- 14.0 6.9 4.8 18.8 20.0 11.1 11.1 20.0 5.6 135 -- -- 2.0 -- -- 3.1 -- -- -- -- -- 142 -- -- 2.0 -- -- 3.1 -- -- 11.1 -- -- 200 -- -- 2.0 -- 4.8 -- -- -- -- -- -- 201 7.4 20.0 2.0 6.9 -- 6.3 10.0 11.1 -- -- -- 355 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 360 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 381 7.4 20.0 -- 10.3 -- -- -- -- -- -- -- 401 3.7 -- 4.0 -- 9.5 3.1 10.0 -- -- 20.0 -- 411 -- -- 2.0 -- -- 3.1 -- -- -- -- -- 422 3.7 -- -- 3.4 -- -- 10.0 -- -- -- -- 424 -- -- 2.0 -- -- 3.1 -- -- -- -- 5.6 425 3.7 -- 12.0 3.4 14.3 9.4 -- 22.2 -- -- 5.6 428 -- -- 6.0 -- 4.8 6.3 10.0 -- 11.1 -- 5.6 501 -- -- 4.0 -- 4.8 3.1 -- 11.1 -- 20.0 -- 502 -- 20.0 -- 3.4 -- -- -- -- -- -- -- 904 11.1 -- 4.0 10.3 -- 6.3 -- -- -- -- 11.1 DH -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 

Q21CH_7 Children: 7th (Least prevalent)

29.6 40.0 18.0 31.0 23.8 15.6 40.0 -- 44.4 -- 33.3 

103 3.7 -- 18.0 3.4 23.8 12.5 20.0 22.2 22.2 -- -- 113 3.7 -- 10.0 3.4 9.5 9.4 -- 11.1 -- 20.0 5.6 114 -- -- 10.0 -- 14.3 6.3 -- 11.1 11.1 -- 5.6 121 14.8 -- 6.0 13.8 4.8 6.3 10.0 -- -- -- 16.7 135 3.7 -- -- 3.4 -- -- -- -- -- -- -- 142 3.7 -- 6.0 -- 9.5 6.3 -- -- 11.1 -- -- 201 3.7 40.0 4.0 10.3 -- 6.3 -- 11.1 -- 20.0 5.6 341 -- -- 2.0 -- -- 3.1 -- -- -- -- 5.6 353 -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 360 -- -- 2.0 -- -- 3.1 10.0 -- -- -- -- 381 7.4 -- 2.0 6.9 -- 3.1 10.0 -- -- -- -- 425 11.1 20.0 10.0 10.3 4.8 15.6 10.0 11.1 11.1 40.0 11.1 427 3.7 -- 2.0 3.4 4.8 -- -- -- -- -- 5.6 428 3.7 -- 2.0 3.4 4.8 -- -- -- -- -- -- 45C -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 903 3.7 -- -- 3.4 -- -- -- -- -- -- -- 904 7.4 -- 2.0 6.9 -- 3.1 -- -- -- 20.0 11.1 DK -- -- 2.0 -- -- 3.1 -- 11.1 -- -- -- 
 C-38 National Surv

Type of Organization Number of Participants Region

ITO 

%

Territory 

%

State/

DC 

%

Up to 

10,000 

%

10,000 to 

75,000 

%

More than 

75,000 

%

Northwest 

%

Mid-Atlantic 

%

Southeast 

%

Midwest

%

Southwe

%

Q21A The codes that the State has written in for each question

Are new VENA FNS codes

74.1 80.0 56.0 75.9 57.1 56.3 50.0 55.6 33.3 60.0 77.8 

Are FNS Codes but are NOT the new VENA codes for dietary risks

7.4 -- 6.0 6.9 4.8 6.3 20.0 -- 11.1 -- -- 

Are own codes, NOT FNS codes

-- -- 14.0 -- 9.5 15.6 10.0 22.2 11.1 20.0 5.6 

Don’t know 18.5 20.0 24.0 17.2 28.6 21.9 20.0 22.2 44.4 20.0 16.7 

TOTAL NUMBER OF AGENCIES 27 5 50 29 21 32 10 9 9 5 18 

Note: Percentages were calculated for all cases.
 C-39 National Surv

Table 19. Denied Applicants

Type of Organization Number of Participants Region

ITO 

%

Territory

%

State/

DC 

%

Up to 

10,000

%

10,000 

to 

75,000 

%

More than 

75,000 

%

Northwest 

%

MidAtlantic 

%

Southeast

%

Midwest

%

Southwe

%

Q23 Does State policy require that local WIC agencies keep information on denied applicants?

YES 85.2 100.0 88.0 89.7 90.5 84.4 80.0 100.0 88.9 80.0 88.9 NO 14.8 -- 12.0 10.3 9.5 15.6 20.0 -- 11.1 20.0 11.1 

Q24 What information on Denied Applicants is required to be retained by the State? 

Q24name Name of applicant 81.5 100.0 86.0 86.2 90.5 81.3 80.0 100.0 77.8 80.0 83.3 Q24adr Address 77.8 20.0 64.0 72.4 81.0 50.0 60.0 77.8 66.7 40.0 77.8 Q24pho Phone number 70.4 20.0 62.0 65.5 81.0 46.9 60.0 66.7 66.7 40.0 66.7 Q24wic WIC applicant category 70.4 80.0 62.0 75.9 76.2 50.0 40.0 66.7 66.7 40.0 83.3 Q24reason Reason for denial 81.5 100.0 86.0 86.2 90.5 81.3 80.0 100.0 88.9 80.0 83.3 Q24applic Date of application 77.8 80.0 68.0 82.8 81.0 56.3 70.0 66.7 77.8 60.0 72.2 Q24denial Date of denial 77.8 100.0 82.0 82.8 90.5 75.0 80.0 88.9 88.9 80.0 72.2 

Q24A How is the Denied Applicant information retained?

No specific retention requirements

14.8 -- 12.0 10.3 9.5 15.6 20.0 -- 11.1 20.0 11.1 

Paper copy only 18.5 40.0 30.0 24.1 33.3 25.0 50.0 44.4 33.3 20.0 11.1 Electronic copy only 33.3 20.0 22.0 31.0 19.0 25.0 -- 22.2 22.2 20.0 55.6 Both paper and electronic 33.3 40.0 36.0 34.5 38.1 34.4 30.0 33.3 33.3 40.0 22.2 

Q25 Is it State policy to have local agencies send an official letter of denial to applicants who are denied eligibility for WIC? 

YES 88.9 60.0 90.0 89.7 90.5 84.4 100.0 88.9 88.9 80.0 88.9 NO 11.1 40.0 10.0 10.3 9.5 15.6 -- 11.1 11.1 20.0 11.1 

TOTAL NUMBER OF AGENCIES 27 5 50 29 21 32 10 9 9 5 18 

Note: Percentages were calculated for all cases.
 C-40 National Surv

Table 20. Assistance that a State provides to local agencies for the specific purpose of promoting breastfeeding

Type of Organization Number of Participants Region

ITO 

%

Territory

%

State/

DC 

%

Up to 

10,000 

%

10,000 to 

75,000 

%

More than 

75,000 

%

Northwest

%

MidAtlantic 

%

Southeast

%

Midwest

%

Southwest

%

Q26fundg Funding for breastfeeding coordinators or peer counselors 81.5 60.0 98.0 79.3 90.5 100.0 70.0 77.8 100.0 100.0 94.4 Q26trng Training for personnel to support breastfeeding 81.5 100.0 100.0 86.2 95.2 100.0 70.0 100.0 100.0 100.0 94.4 Q26prntd Printed breastfeeding materials (hand-outs, posters, etc.) 81.5 100.0 100.0 86.2 95.2 100.0 70.0 100.0 100.0 100.0 94.4 Q26free Free breast pumps for distribution 85.2 100.0 98.0 89.7 95.2 96.9 80.0 88.9 100.0 100.0 94.4 Q26_O Other 7.4 -- 16.0 6.9 19.0 12.5 30.0 11.1 11.1 20.0 11.1 Q26none None 14.8 -- -- 10.3 4.8 -- 20.0 -- -- -- 5.6 TOTAL NUMBER OF AGENCIES 27 5 50 29 21 32 10 9 9 5 18 

Note: Percentages were calculated for all cases.
 C-41 National Surv

Table 21. Actions that are designated proxies allowed to do in a State on behalf of the WIC participants they represent

Type of Organization Number of Participants Region

ITO 

%

Territory

%

State/

DC 

%

Up to 

10,000

%

10,000 

to 

75,000 

%

More than 

75,000 

%

Northwest 

%

MidAtlantic 

%

Southeast

%

Midwest

%

Southwes

%

Q27get Get certification for the WIC applicant 55.6 40.0 42.0 55.2 42.9 40.6 20.0 33.3 55.6 -- 61.1 Q27pick Pick up food instruments 92.6 100.0 96.0 93.1 95.2 96.9 80.0 100.0 88.9 100.0 100.0 Q27attend Attend educational sessions 70.4 100.0 86.0 75.9 76.2 90.6 40.0 88.9 66.7 100.0 88.9 Q27spend Spend food instruments 92.6 100.0 92.0 93.1 85.7 96.9 80.0 88.9 88.9 100.0 100.0 Q27_O Other -- -- 10.0 -- 9.5 9.4 10.0 22.2 11.1 -- -- Q27NA Not Applicable. State does not allow proxies 3.7 -- 2.0 3.4 -- 3.1 10.0 -- 11.1 -- -- TOTAL NUMBER OF AGENCIES 27 5 50 29 21 32 10 9 9 5 18 

Note: Percentages were calculated for all cases.
 C-42 National Surv

Table 22. How frequently are food instruments distributed throughout the State via the following distribution methods 

Type of Organization Number of Participants Region

ITO 

%

Territory

%

State/

DC 

%

Up to 

10,000

%

10,000 

to 

75,000 

%

More than 

75,000 

%

Northwest 

%

MidAtlantic 

%

Southeast

%

Midwest

%

Southwe

%

Q28a In person at a local WIC site

Most of the time 100.0 100.0 98.0 100.0 95.2 100.0 90.0 100.0 100.0 100.0 100.0 Some of the time -- -- -- -- -- -- -- -- -- -- -- Occasionally -- -- -- -- -- -- -- -- -- -- -- Not at all -- -- 2.0 -- 4.8 -- 10.0 -- -- -- -- 

Q28b EBT (electronic benefit cards)

Most of the time 7.4 -- 10.0 6.9 14.3 6.3 -- -- -- 20.0 16.7 Some of the time -- -- 2.0 -- -- 3.1 -- -- 11.1 -- -- Occasionally -- 20.0 -- 3.4 -- -- -- -- -- -- -- Not at all 92.6 80.0 88.0 89.7 85.7 90.6 100.0 100.0 88.9 80.0 83.3 

Q28c By mail

Most of the time -- -- 2.0 -- 4.8 -- -- 11.1 -- -- -- Some of the time 11.1 -- 4.0 10.3 9.5 -- 10.0 -- -- -- -- Occasionally 59.3 20.0 78.0 51.7 57.1 90.6 30.0 66.7 88.9 100.0 83.3 Not at all 29.6 80.0 16.0 37.9 28.6 9.4 60.0 22.2 11.1 -- 16.7 

Q28d Other

Most of the time -- -- 4.0 -- 9.5 -- 10.0 -- -- -- -- Some of the time 3.7 -- -- 3.4 -- -- -- -- -- -- -- Occasionally 11.1 -- -- 6.9 4.8 -- -- -- 11.1 -- 5.6 Not at all 85.2 100.0 96.0 89.7 85.7 100.0 90.0 100.0 88.9 100.0 94.4 

TOTAL NUMBER OF AGENCIES 27 5 50 29 21 32 10 9 9 5 18 

Note: Percentages were calculated for all cases.
 C-43 National Surv

Table 23. For how long, if at all, the following WIC Participant data is kept at the State level

Type of Organization Number of Participants Region

ITO 

%

Territory

%

State/

DC 

%

Up to 

10,000

%

10,000 

to 

75,000 

%

More 

than 

75,000 

%

Northwest 

%

MidAtlantic 

%

Southeast 

%

Midwest

%

Southwe

%

Q29a Client name

State stores only most current information 7.4 20.0 18.0 10.3 14.3 18.8 30.0 22.2 22.2 20.0 5.6 State stores current and previous information for over a year

92.6 80.0 82.0 89.7 85.7 81.3 70.0 77.8 77.8 80.0 94.4 

Q29b Clinic attended

State does not retain this information 11.1 20.0 6.0 13.8 9.5 3.1 20.0 -- 11.1 -- -- State stores only most current information 7.4 -- 6.0 6.9 4.8 6.3 -- 11.1 -- 20.0 5.6 State stores current and previous information for over a year

81.5 80.0 88.0 79.3 85.7 90.6 80.0 88.9 88.9 80.0 94.4 

Q29c Family identification or affiliation

State does not retain this information 3.7 -- 2.0 3.4 -- 3.1 -- -- 11.1 -- -- State stores only most current information 3.7 20.0 16.0 6.9 14.3 15.6 20.0 11.1 11.1 20.0 5.6 State stores current and previous information for over a year

92.6 80.0 82.0 89.7 85.7 81.3 80.0 88.9 77.8 80.0 94.4 

Q29d Category of eligibility

State does not retain this information 7.4 -- 2.0 6.9 -- 3.1 10.0 -- 11.1 -- -- State stores only most current information 3.7 -- 4.0 3.4 9.5 -- -- -- -- -- 5.6 State stores current and previous information for over a year

88.9 100.0 94.0 89.7 90.5 96.9 90.0 100.0 88.9 100.0 94.4 

Q29e Client address 

State does not retain this information 3.7 -- 2.0 3.4 -- 3.1 -- -- 11.1 -- -- State stores only most current information 3.7 20.0 22.0 6.9 19.0 21.9 30.0 22.2 22.2 20.0 5.6 State stores current and previous information for over a year

92.6 80.0 76.0 89.7 81.0 75.0 70.0 77.8 66.7 80.0 94.4 

Q29f Client telephone

State does not retain this information 3.7 -- 2.0 3.4 -- 3.1 -- -- 11.1 -- -- State stores only most current information 11.1 20.0 22.0 10.3 23.8 21.9 30.0 22.2 22.2 20.0 5.6 State stores current and previous information for over a year

85.2 80.0 76.0 86.2 76.2 75.0 70.0 77.8 66.7 80.0 94.4 

Q29g Second client telephone

State does not retain this information 14.8 20.0 22.0 17.2 28.6 15.6 40.0 22.2 22.2 20.0 5.6 
 C-44 National Surv

Type of Organization Number of Participants Region

ITO 

%

Territory

%

State/

DC 

%

Up to 

10,000

%

10,000 

to 

75,000 

%

More 

than 

75,000 

%

Northwest 

%

MidAtlantic 

%

Southeast 

%

Midwest

%

Southwe

%

State stores only most current information 11.1 20.0 14.0 10.3 14.3 15.6 -- 22.2 11.1 20.0 5.6 State stores current and previous information for over a year

74.1 60.0 64.0 72.4 57.1 68.8 60.0 55.6 66.7 60.0 88.9 

Q29h Food package issued

State does not retain this information 11.1 -- 2.0 10.3 -- 3.1 10.0 -- 11.1 -- 5.6 State stores only most current information -- 20.0 2.0 3.4 4.8 -- -- 11.1 -- -- -- State stores current and previous information for over a year

88.9 80.0 96.0 86.2 95.2 96.9 90.0 88.9 88.9 100.0 94.4 

Q29i Value of food package redeemed

State does not retain this information 18.5 -- 10.0 17.2 9.5 9.4 20.0 -- 33.3 -- 5.6 State stores only most current information 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 State stores current and previous information for 9-12 months

-- -- 2.0 -- -- 3.1 -- -- -- 20.0 -- 

State stores current and previous information for over a year

77.8 100.0 88.0 79.3 90.5 87.5 80.0 100.0 66.7 80.0 88.9 

Q29j Program through which adjunctively/ automatically income eligible

State does not retain this information 3.7 -- 8.0 3.4 9.5 6.3 10.0 11.1 11.1 -- -- State stores only most current information 3.7 20.0 10.0 6.9 14.3 6.3 10.0 33.3 -- 20.0 5.6 State stores current and previous information for 4-8 months

3.7 -- -- 3.4 -- -- 10.0 -- -- -- -- 

State stores current and previous information for over a year

88.9 80.0 82.0 86.2 76.2 87.5 70.0 55.6 88.9 80.0 94.4 

Q29k Proofs of income (if not adjunctively/auto¬matically eligible)

State does not retain this information 7.4 20.0 24.0 10.3 33.3 15.6 20.0 22.2 33.3 -- -- State stores only most current information 7.4 40.0 4.0 13.8 -- 6.3 -- 22.2 -- -- 5.6 State stores current and previous information for 4-8 months

3.7 -- -- 3.4 -- -- 10.0 -- -- -- -- 

State stores current and previous information for over a year

81.5 40.0 72.0 72.4 66.7 78.1 70.0 55.6 66.7 100.0 94.4 
 C-45 National Surv

Type of Organization Number of Participants Region

ITO 

%

Territory

%

State/

DC 

%

Up to 

10,000

%

10,000 

to 

75,000 

%

More 

than 

75,000 

%

Northwest 

%

MidAtlantic 

%

Southeast 

%

Midwest

%

Southwe

%

Q29l Primary language

State does not retain this information 18.5 20.0 20.0 13.8 28.6 18.8 30.0 44.4 33.3 -- 11.1 State stores only most current information 11.1 -- 18.0 6.9 14.3 21.9 10.0 22.2 11.1 20.0 5.6 State stores current and previous information for over a year

70.4 80.0 62.0 79.3 57.1 59.4 60.0 33.3 55.6 80.0 83.3 

TOTAL NUMBER OF AGENCIES 27 5 50 29 21 32 10 9 9 5 18 

Note: Percentages were calculated for all cases.
 C-46 National Surv

Table 24. Proofs of eligibility that are local WIC agencies required to keep in their files

Type of Organization Number of Participants Regio

ITO 

%

Territory

%

State/DC

%

Up to 

10,000 

%

10,000 

to 

75,000 

%

More 

than 

75,000 

%

Northwest

%

MidAtlantic 

%

Southeast

%

Midwest

%

Q30_ADJ_1 Local agency must keep Documents proving adjunctive/automatic eligibility: Original documents

11.1 20.0 2.0 13.8 4.8 -- -- -- 11.1 -- 

Q30_ADJ_2 Local agency must keep Documents proving adjunctive/automatic eligibility: Copy of original documents

55.6 20.0 12.0 51.7 9.5 15.6 30.0 22.2 11.1 20.0 

Q30_ADJ_3 Local agency must keep Documents proving adjunctive/automatic eligibility: Identifying number of original documents

7.4 -- 16.0 6.9 23.8 9.4 30.0 11.1 -- 20.0 

Q30_ADJ_4 Local agency must keep Documents proving adjunctive/automatic eligibility: A written statement that an acceptable document was shown to the (re)certification staff

25.9 60.0 60.0 31.0 71.4 50.0 50.0 55.6 33.3 100.0 

Q30_ADJ_5 Local agency must keep Documents proving adjunctive/automatic eligibility: None of these items

18.5 -- 26.0 13.8 14.3 34.4 10.0 22.2 44.4 -- 

Q30_INC_1 Local agency must keep Proofs of income: Original documents 3.7 20.0 -- 6.9 -- -- -- -- -- -- Q30_INC_2 Local agency must keep Proofs of income: Copy of original documents 59.3 40.0 14.0 58.6 14.3 15.6 30.0 44.4 22.2 20.0 Q30_INC_3 Local agency must keep Proofs of income: Identifying number of original documents 3.7 -- 6.0 3.4 4.8 6.3 10.0 -- -- 20.0 Q30_INC_4 Local agency must keep Proofs of income: A written statement that an acceptable document was shown to the (re)certification staff

33.3 40.0 62.0 34.5 76.2 50.0 50.0 44.4 33.3 100.0 

Q30_INC_5 Local agency must keep Proofs of income: None of these items 18.5 -- 28.0 13.8 19.0 34.4 10.0 11.1 44.4 -- Q30_NUT_1 Local agency must keep Nutritional eligibility paperwork: Original documents 33.3 -- 48.0 31.0 52.4 40.6 80.0 11.1 66.7 20.0 Q30_NUT_2 Local agency must keep Nutritional eligibility paperwork: Copy of original documents 22.2 20.0 10.0 20.7 4.8 15.6 -- 22.2 22.2 20.0 Q30_NUT_3 Local agency must keep Nutritional eligibility paperwork: Identifying number of original documents

-- 20.0 -- 3.4 -- -- -- -- -- -- 

Q30_NUT_4 Local agency must keep Nutritional eligibility paperwork: A written statement that an acceptable document was shown to the (re)certification staff

14.8 60.0 30.0 24.1 19.0 34.4 20.0 44.4 -- 60.0 

Q30_NUT_5 Local agency must keep Nutritional eligibility paperwork: None of these items 33.3 -- 24.0 24.1 28.6 25.0 10.0 22.2 22.2 20.0 Q30_CAT_1 Local agency must keep Categorical eligibility paperwork: Original documents 33.3 -- 14.0 31.0 19.0 9.4 40.0 -- 22.2 -- 
 C-47 National Surv

Type of Organization Number of Participants Regio

ITO 

%

Territory

%

State/DC

%

Up to 

10,000 

%

10,000 

to 

75,000 

%

More 

than 

75,000 

%

Northwest

%

MidAtlantic 

%

Southeast

%

Midwest

%

Q30_CAT_2 Local agency must keep Categorical eligibility paperwork: Copy of original documents 25.9 -- 16.0 24.1 14.3 15.6 -- 22.2 33.3 20.0 Q30_CAT_3 Local agency must keep Categorical eligibility paperwork: Identifying number of original documents

-- 20.0 4.0 3.4 -- 6.3 10.0 -- -- 20.0 

Q30_CAT_4 Local agency must keep Categorical eligibility paperwork: A written statement that an acceptable document was shown to the (re)certification staff

14.8 40.0 48.0 20.7 38.1 50.0 30.0 33.3 11.1 100.0 

Q30_CAT_5 Local agency must keep Categorical eligibility paperwork: None of these items 29.6 40.0 26.0 24.1 33.3 28.1 20.0 44.4 33.3 -- 

Q30_RES_1 Local agency must keep Proof of residency: Original documents 7.4 -- -- 6.9 -- -- 10.0 -- -- -- Q30_RES_2 Local agency must keep Proof of residency: Copy of original documents 55.6 60.0 10.0 58.6 9.5 12.5 20.0 33.3 22.2 20.0 Q30_RES_3 Local agency must keep Proof of residency: Identifying number of original documents 3.7 -- 6.0 3.4 4.8 6.3 10.0 -- -- 20.0 Q30_RES_4 Local agency must keep Proof of residency: A written statement that an acceptable document was shown to the (re)certification staff

29.6 40.0 66.0 31.0 81.0 53.1 50.0 44.4 33.3 100.0 

Q30_RES_5 Local agency must keep Proof of residency: None of these items 18.5 -- 28.0 13.8 19.0 34.4 10.0 22.2 44.4 -- TOTAL NUMBER OF AGENCIES 27 5 50 29 21 32 10 9 9 5 

Note: Percentages were calculated for all cases.
 C-48 National Surv

Table 25. Proofs of eligibility that are stored at the State level

Type of Organization Number of Participants Region

ITO 

%

Territory

%

State/DC

%

Up to 

10,000 

%

10,000 to 

75,000 

%

More than 

75,000 

%

Northwest

%

MidAtlantic 

%

Southeast

%

Midwest

%

Southwest

%

Q31a Documents proving adjunctive/automatic eligibility 77.8 80.0 16.0 75.9 28.6 15.6 50.0 22.2 22.2 -- 38.9 Q31b Proofs of income 74.1 80.0 12.0 72.4 23.8 12.5 50.0 22.2 22.2 -- 38.9 Q31c Nutritional eligibility paperwork 66.7 80.0 14.0 72.4 14.3 15.6 40.0 22.2 33.3 20.0 33.3 Q31d Categorical eligibility paperwork 66.7 60.0 12.0 72.4 14.3 9.4 40.0 11.1 33.3 -- 33.3 Q31e Proof of residency 70.4 80.0 10.0 69.0 19.0 12.5 50.0 22.2 22.2 -- 33.3 Q31F None of these -- -- 6.0 -- 4.8 6.3 -- -- 22.2 -- 5.6 TOTAL NUMBER OF AGENCIES 27 5 50 29 21 32 10 9 9 5 18 

Note: Percentages were calculated for all cases.
 C-49 National Surv

Table 26. The longest that local agencies may wait before sending applicant data to the State WIC agency

Type of Organization Number of Participants Region

ITO 

%

Territory

%

State/DC

%

Up to 

10,000

%

10,000 to 

75,000 

%

More than 

75,000 

%

Northwest 

%

MidAtlantic

%

Southeast

%

Midwest

%

Southwes

%

Q32 32. What is the longest that local agencies may wait before sending applicant data to the State WIC agency about new WIC certificants and recertificants?

30 days or less 29.6 20.0 28.0 24.1 38.1 25.0 50.0 22.2 33.3 20.0 5.6 31-60 days 3.7 -- -- 3.4 -- -- -- -- -- -- 5.6 61-90 days 3.7 -- -- 3.4 -- -- 10.0 -- -- -- -- Real time 7.4 20.0 38.0 10.3 23.8 43.8 -- 55.6 33.3 80.0 22.2 Daily -- 20.0 22.0 -- 28.6 18.8 20.0 22.2 22.2 -- 5.6 Don’t know 55.6 40.0 12.0 58.6 9.5 12.5 20.0 -- 11.1 -- 61.1 

TOTAL NUMBER OF AGENCIES 27 5 50 29 21 32 10 9 9 5 18 

Note: Percentages were calculated for all cases.
 C-50 National Surv

Table 27. The State’s database of WIC participants

Type of Organization Number of Participants Region

ITO 

%

Territory

%

State/DC

%

Up to 

10,000

%

10,000 to 

75,000 

%

More than 

75,000 

%

Northwest 

%

MidAtlantic

%

Southeast

%

Midwest

%

Southwes

%

Q33_1 What does State use to store participant data?

Mainframe server 22.2 40.0 44.0 27.6 47.6 37.5 50.0 33.3 55.6 40.0 27.8 QuickWIC (webbased) 7.4 20.0 4.0 10.3 -- 6.3 -- 22.2 -- 20.0 11.1 Other 55.6 40.0 48.0 48.3 52.4 50.0 30.0 33.3 33.3 40.0 55.6 Don’t know 14.8 -- 4.0 13.8 -- 6.3 20.0 11.1 11.1 -- 5.6 

Q33_2 What databases are used? 

Access (MDB) 3.7 -- 2.0 3.4 -- 3.1 -- -- 11.1 -- 5.6 Excel (XLS) 7.4 -- 2.0 6.9 -- 3.1 -- -- 11.1 -- 5.6 Oracle 3.7 40.0 28.0 6.9 28.6 28.1 20.0 44.4 11.1 60.0 5.6 SAS -- -- -- -- -- -- -- -- -- -- -- SPSS (SPS) -- -- -- -- -- -- -- -- -- -- -- XML 3.7 -- -- -- 4.8 -- -- -- -- -- -- Other 51.9 40.0 62.0 51.7 66.7 56.3 70.0 33.3 55.6 40.0 55.6 Don’t know 29.6 20.0 6.0 31.0 -- 9.4 10.0 22.2 11.1 -- 27.8 

TOTAL NUMBER OF AGENCIES 27 5 50 29 21 32 10 9 9 5 18 

Note: Percentages were calculated for all cases.
 C-51 National Surv

Table 28. The maximum number of days that... 

Type of Organization Number of Participants Regio

ITO 

%

Territory

%

State/DC

%

Up to 

10,000 

%

10,000 

to 

75,000 

%

More 

than 

75,000 

%

Northwest

%

MidAtlantic 

%

Southeast

%

Midwest

%

Q34a What is the maximum number of days that participants are given to use their food instruments after start date?

0 -- -- 2.0 -- -- 3.1 -- 11.1 -- -- 

30 88.9 100.0 86.0 89.7 81.0 90.6 90.0 88.9 77.8 100.0 31 3.7 -- 4.0 3.4 9.5 -- -- -- -- -- 34 -- -- 2.0 -- 4.8 -- -- -- -- -- 60 3.7 -- -- 3.4 -- -- -- -- -- -- 75 -- -- 2.0 -- -- 3.1 -- -- 11.1 -- 

Q34a What is the maximum number of days that participants are given to use their food instruments after start date? (AVERAGE)

31.2 30.0 30.4 31.1 30.3 30.5 30.0 26.7 35.6 30.0 

N=26 N=5 N=48 N=28 N=20 N=31 N=9 N=9 N=8 N=5 

Q34b What is the maximum number of days that vendors can take to deposit redeemed food instruments in their bank? 

1 -- -- 2.0 -- 4.8 -- -- -- -- -- 

10 3.7 -- -- 3.4 -- -- -- -- -- -- 15 -- -- 2.0 -- -- 3.1 -- -- -- -- 30 25.9 40.0 20.0 31.0 9.5 25.0 10.0 44.4 22.2 20.0 45 3.7 -- 8.0 -- 9.5 9.4 -- -- 11.1 20.0 60 40.7 40.0 48.0 41.4 57.1 40.6 40.0 33.3 44.4 20.0 90 3.7 -- 2.0 3.4 4.8 -- 10.0 -- -- -- 

Q34b What is the maximum number of days that vendors can take to deposit redeemed food instruments in their bank? (AVERAGE)

48.3 45.0 49.4 47.4 53.4 46.8 60.0 42.9 49.3 45.0 

N=21 N=4 N=41 N=23 N=18 N=25 N=6 N=7 N=7 N=3 

Q34c What is the maximum number of days that vendors’ banks can take to turn the food instruments over to the State WIC agency’s bank? 

1 -- -- 8.0 -- 9.5 6.3 -- -- -- 20.0 2 -- -- 4.0 -- 4.8 3.1 -- -- -- -- 3 -- -- 2.0 -- -- 3.1 10.0 -- -- -- 5 -- -- 2.0 -- 4.8 -- -- 11.1 -- -- 

30 18.5 -- 16.0 17.2 9.5 18.8 10.0 33.3 22.2 20.0 60 11.1 -- 16.0 10.3 23.8 9.4 -- 11.1 11.1 20.0 67 -- -- 2.0 -- 4.8 -- -- -- -- -- 90 11.1 -- 2.0 6.9 4.8 3.1 -- -- 11.1 -- 

Q34c What is the maximum number of days that vendors’ banks can take to turn the food instruments over to the State WIC agency’s bank? (AVERAGE) 

54.5 -- 34.3 51.0 40.5 32.6 16.5 31.0 52.5 30.3 

N=11 N=0 N=26 N=10 N=13 N=14 N=2 N=5 N=4 N=3 

Q34_1chbox The question does not apply because vendors must turn in their coupons to the State WIC agency’s bank

-- -- 4.0 -- 4.8 3.1 10.0 -- 11.1 -- 

TOTAL NUMBER OF AGENCIES 27 5 50 29 21 32 10 9 9 5 

Note 1: Percentages were calculated for all cases. Note 2: Averages were calculated for cases with valid data.
 C-52 National Surv

Table 29. General characteristics

Type of Organization Number of Participants Region

ITO 

%

Territory

%

State/DC

%

Up to 

10,000 

%

10,000 to 

75,000 

%

More 

than 

75,000 

%

Northwest

%

MidAtlantic 

%

Southeast

%

Midwest

%

Southwest

%

Q35ad For the State as a whole, some WIC clients are migrant farmworkers >0%

7.4 20.0 84.0 3.4 81.0 84.4 40.0 88.9 66.7 100.0 16.7 

Q35a For the State as a whole, how many WIC clients are migrant farmworkers (AVERAGE) 

3.0 12.0 1763.5 4.0 37.5 2720.1 501.0 401.9 1497.0 1367.4 15513.7 

N=2 N=1 N=42 N=1 N=17 N=27 N=4 N=8 N=6 N=5 N=3 

Q35bd For the State as a whole, some WIC clients are homeless individuals >0%

14.8 40.0 74.0 10.3 85.7 68.8 40.0 66.7 44.4 80.0 27.8 

Q35b For the State as a whole, how many WIC clients are homeless individuals (AVERAGE)

16.0 90.5 576.2 8.0 112.9 886.7 123.0 99.5 62.5 1232.3 1277.4 

N=4 N=2 N=37 N=3 N=18 N=22 N=4 N=6 N=4 N=4 N=5 

Q36 What is the number of WIC local agencies in the State? (AVERAGE)

2.0 20.2 39.7 1.3 15.5 55.4 18.7 25.0 38.8 68.6 16.9 

N=27 N=5 N=50 N=29 N=21 N=32 N=10 N=9 N=9 N=5 N=18 

Q37 What is the number of WIC clinics or sites, including satellite sites in the State? (AVERAGE)

7.3 3.8 144.5 5.2 54.7 192.0 91.0 89.7 130.0 205.2 60.4 

N=27 N=5 N=50 N=29 N=21 N=32 N=10 N=9 N=9 N=5 N=18 

TOTAL NUMBER OF AGENCIES 27 5 50 29 21 32 10 9 9 5 18 

Note 1: Percentages were calculated for all cases. Note 2: Averages were calculated for cases with valid data.
APPENDIX D: 

DATA TABLES FOR LOCAL WIC

AGENCY SURVEY
 D-1 National Survey of WIC Participants II 

Table 01. Interrelationships of Characteristics of Local WIC Agency, unweighted data

Clients served at the whole agency (administrative data)

<750 750-1,999 2,000-4,500 >4,500 Total

The relationship of WIC local to 

State agency

State affiliated 34.9% 40.6% 25.8% 20.9% 27.0% 

Local government 48.8% 41.7% 37.5% 46.3% 43.5% 

Non- government 16.3% 17.7% 36.7% 32.8% 29.4% 

TOTAL 43 96 120 244 503 

Note: Percentages were calculated for all cases. 

Table 02. Interrelationships of Characteristics of Local WIC Agency, unweighted data

The relationship of WIC local to State agency

State affiliated Local government Non- government Total

Clients served at the whole agency (administrative data)

<750 11.0% 9.6% 4.7% 8.5% 

750-1,999 28.7% 18.3% 11.5% 19.1%

2,000-4,500 22.8% 20.5% 29.7% 23.9%

>4,500 37.5% 51.6% 54.1% 48.5%

TOTAL 136 219 148 503 

Note: Percentages were calculated for all cases. 

Table 03. Interrelationships of Characteristics of Local WIC Agency, weighted data

Clients served at the whole agency (administrative data)

<750 750-1,999 2,000-4,500 >4,500 Total

The relationship of WIC local to 

State agency

State affiliated 30.2% 38.9% 26.5% 20.4% 29.3% 

Local government 54.0% 42.5% 36.3% 44.9% 44.5% 

Non- government 15.9% 18.6% 37.3% 34.7% 26.2% 

TOTAL 578 625 528 560 2291 

Note: Percentages were calculated for all cases. 

Table 04. Interrelationships of Characteristics of Local WIC Agency, weighted data

The relationship of WIC local to State agency

State affiliated Local government Non- government Total

Clients served at the whole agency (administrative data)

<750 26.0% 30.6% 15.3% 25.2%

750-1,999 36.2% 26.0% 19.4% 27.3%

2,000-4,500 20.8% 18.8% 32.9% 23.1%

>4,500 17.0% 24.6% 32.4% 24.4%

TOTAL 671 1020 599 2291 

Note: Percentages were calculated for all cases. 
 D-2 National Surv

Table 1. Characteristics of Local WIC Agency: Facilities

The relationship of WIC local to State agency Clients served at the whole 

State affiliated Local government Non-government <750 750-1,999 2,000

s1 Does this local agency conduct certifications and recertifications of WIC applicants, or does it serve as a purely administrative office, overseeing these functions at the clinic level?

1-Agency to which this survey was addressed does certification

100.0% 100.0% 100.0% 100.0% 100.0% 10

q1 Which description most closely fits the structure in which your local agency or clinic is located? (A***; B*)

Health department, health center, or medical clinic 85.7% 91.0% 30.5% 81.1% 79.1% 66Social services office, WIC, or other agency 9.7% 3.4% 10.4% 3.5% 8.1% 9Full service hospital or satellite -- 4.1% 16.9% 11.8% 2.2% 6School -- -- -- -- -- Site of non-profit organization 4.7% 1.4% 42.2% 3.5% 10.7% 17Site of religious group -- -- -- -- -- 

q2_01_D Large waiting rooms/reception areas (greater than 15x15 feet) (A n.s.; B***) 66.8% 70.5% 66.7% 51.9% 71.6% 69q2_01 Large waiting rooms/reception areas (greater than 15x15 feet) (A n.s.; B**)

1.3 1.5 1.4 1.0 1.2 1

(1.1) (1.7) (1.7) (.2) (.7) (

N=448 N=719 N=400 N=300 N=447 N=

q2_02_D Small waiting rooms/reception areas (15x15 feet or smaller) (A n.s.; B n.s.) 59.6% 47.0% 51.9% 49.2% 49.6% 54q2_02 Small waiting rooms/reception areas (15x15 feet or smaller) (A n.s.; B**)

1.3 1.4 1.5 1.1 1.2 1

(.9) (1.5) (1.4) (.3) (.6) (

N=400 N=480 N=311 N=284 N=310 N=

q2_03_D Rooms, offices or cubicles where clients are seen (A n.s.; B n.s.) 98.5% 95.3% 94.3% 97.1% 97.2% 95q2_03 Rooms, offices or cubicles where clients are seen (A n.s.; B***)

5.2 5.7 6.5 2.7 4.3 6

(3.9) (4.8) (4.8) (1.5) (2.2) (3

N=661 N=972 N=565 N=561 N=607 N=

q2_04_D Large training/conference/multipurpose rooms (A n.s.; B***) 40.5% 39.2% 44.5% 25.7% 37.7% 42q2_04 Large training/conference/multipurpose rooms (A n.s.; B n.s.)

1.2 1.4 1.4 1.1 1.1 1

(.7) (1.5) (1.0) (.3) (.5) (

N=272 N=400 N=267 N=149 N=235 N=

q2_05_D Small training/conference/multipurpose rooms (A**; B**) 42.3% 38.9% 53.8% 26.1% 47.6% 49q2_05 Small training/conference/multipurpose rooms (A*; B**)

1.1 1.6 1.5 1.2 1.2 1

(.6) (2.1) (1.7) (.5) (.6) (

N=284 N=396 N=322 N=151 N=297 N=
 D-3 National Surv

The relationship of WIC local to State agency Clients served at the whole 

State affiliated Local government Non-government <750 750-1,999 2,000

q2_06_D Administrative offices (no clients seen) (A**; B***) 41.2% 52.4% 60.6% 29.5% 42.3% 59q2_06 Administrative offices (no clients seen) (A n.s.; B***)

1.9 2.0 2.0 1.4 1.5 1

(2.1) (1.8) (1.8) (.7) (.7) (1

N=276 N=534 N=363 N=170 N=264 N=

q2_07_D Administrative cubicles (no clients seen) (A n.s.; B*) 17.0% 19.7% 24.3% 17.3% 12.1% 21q2_07 Administrative cubicles (no clients seen) (A**; B**)

2.9 3.5 2.3 2.0 2.1 3

(2.6) (3.5) (2.4) (1.3) (2.1) (3

N=114 N=201 N=145 N=100 N=75 N=

q2_951_D Other (A n.s.; B n.s.) 19.9% 17.5% 15.7% 13.0% 20.8% 17q2_951 Other: Please Specify (A n.s.; B*)

2.0 2.6 3.5 1.7 2.0 2

(2.4) (3.5) (4.7) (1.1) (1.7) (2

N=133 N=179 N=94 N=75 N=130 N

TOTAL 671 1020 599 578 625 5Note 1: Percentages were calculated for all cases. Note 2: Averages were calculated for cases with valid data (>0) Note 3: Standard deviations for the averages are in parenthesis. NOTE A applies to the RELATIONSHIP crosstab (columns 1-3): ***p<.0001; **p<.01; *p<.05; n.s. non-significant NOTE B applies to the SIZE crosstab (columns 4-7): ***p<.0001; **p<.01; *p<.05 n.s. non-significant 
 D-4 National Surv

Table 2. Characteristics of Local WIC Agency: Operations

The relationship of WIC local to State agency Clients served at the whole 

State affiliated Local government Non- government <750 750-1,999 2,00

q3 How many days a week, on average, is the agency open to clients/applicants? Days: (A--; B--)

1 5.9% 5.3% -- 15.4% -- 2 -- 1.7% 4.3% 4.8% 1.8% 3 5.2% 3.5% 2.4% 11.5% 2.4% 4 2.0% 5.0% 11.3% 3.3% 10.0% 55 85.1% 80.5% 72.6% 65.0% 84.7% 876 1.5% 3.0% 8.0% -- -- 47 .2% 1.0% 1.4% -- 1.1% 1

q3 How many days a week, on average, is the agency open to clients/applicants? Days: (A n.s.; B**)

4.7 4.7 4.8 4.0 4.8 

(1.0) (1.1) (.8) (1.5) (.6) 

N=671 N=1020 N=599 N=578 N=625 N

q4 How many hours per week, on average, is the WIC agency open? Hours: (A*; B***)

35.8 34.7 38.7 31.4 36.1 3

(12.3) (12.5) (10.8) (12.4) (9.5) (1

N=671 N=1020 N=599 N=578 N=625 N

q5 How many of the hours are extended hours, meaning they take place before 9 AM and after 5 PM? Hours: (A**; B***)

4.0 4.5 6.4 2.5 4.7 

(5.1) (5.1) (5.7) (2.3) (5.1) (

N=671 N=1020 N=599 N=578 N=625 N

q6 Approximately how many clients are served at the agency per month? Clients (no commas): (A***; B***)

1555.4 3070.5 3752.6 239.3 822.5 21

(3891.9) (8464.2) (7396.6) (215.5) (528.8) (15

N=671 N=1020 N=599 N=578 N=625 N

q7 Of these, approximately what percentage are certifications and recertifications? Range (0-100%): (A n.s.; B n.s.)

49.9 47.3 48.1 44.5 52.0 4

(21.1) (21.7) (19.3) (23.3) (21.8) (1

N=671 N=1020 N=599 N=578 N=625 N

TOTAL 671 1020 599 578 625 5Note 1: Percentages were calculated for all cases. Note 2: Averages were calculated for all cases Note 3: Standard deviations for the averages are in parenthesis. NOTE A applies to the RELATIONSHIP crosstab (columns 1-3): ***p<.0001; **p<.01; *p<.05; n.s. non-significant; -- N/A for the clients served crosstab. NOTE B applies to the SIZE crosstab (columns 4-7): ***p<.0001; **p<.01; *p<.05 n.s. non-significant; -- N/A for the clients served crosstab.
 D-5 National Surv

Table 2A. Local WIC Agency: Number of Clients

The relationship of WIC local to State agency Clients served at the whole 

State affiliated Local government Non- government <750 750-1,999 2,00

Clients served at the whole agency (administrative data) (A***; B--)

<750 26.0% 30.6% 15.3% 100.0% -- 750-1,999 36.2% 26.0% 19.4% -- 100.0% 2,000-4,500 20.8% 18.8% 32.9% -- -- 10>4,500 17.0% 24.6% 32.4% -- -- Total 100.0% 100.0% 100.0% 100.0% 100.0% 10

Clients served at the agency (administrative data) (A***; B***)

3024.1 4570.6 6117.8 333.2 1270.7 29

(5120.7) (9633.4) (17542.7) (183.3) (371.6) (6

N=671 N=1020 N=599 N=578 N=625 N

Clients served at the site (selfreport data) (A***; B***)

<350 25.7% 31.5% 14.0% 82.1% 12.1% 2350 to 999 40.2% 20.7% 21.9% 16.0% 59.1% 231,000 to 2,999 18.9% 26.5% 31.0% 1.9% 28.8% 43,000+ 15.3% 21.3% 33.1% -- -- 32

q6 Approximately how many clients are served at the agency per month? Clients (no commas): (A***; B***)

1555.4 3070.5 3752.6 239.3 822.5 21

(3891.9) (8464.2) (7396.6) (215.5) (528.8) (15

N=671 N=1020 N=599 N=578 N=625 N

TOTAL 671 1020 599 578 625 5Note 1: Percentages and averages were calculated for all cases. Note 2: Standard deviations for the averages are in parenthesis. 

NOTE A applies to the RELATIONSHIP crosstab (columns 1-3): ***p<.0001; **p<.01; *p<.05; n.s. non-significant ; -- N/A for the clients served crosstab. 

NOTE B applies to the SIZE crosstab (columns 4-7): ***p<.0001; **p<.01; *p<.05 n.s. non-significant; -- N/A for the clients served crosstab. 
 D-6 National Surv

Table 3. Characteristics of Local WIC Agency: Transportation and Security

The relationship of WIC local to State agency Clients served at the whole 

State affiliated Local government Non- government <750 750-1,999 2,00

q8_1 Public transportation within a 10 minute walk (1/2 mile) of the agency: Bus( A**; B***) 33.5% 46.1% 59.5% 9.2% 24.9% 72q8_2 Public transportation within a 10 minute walk (1/2 mile) of the agency: Light rail/subway/commuter train (A***; B*) 2.0% 4.3% 19.7% -- 2.4% 1q8_3 Public transportation within a 10 minute walk (1/2 mile) of the agency: Other (A n.s; B*) 13.8% 17.8% 9.1% 23.1% 15.2% 9q8_4 Public transportation within a 10 minute walk (1/2 mile) of the agency: None (A*; B***) 56.1% 42.2% 35.0% 70.8% 62.0% 24q9 What is the most-frequent means of transport used by WIC applicants and participants to get to your agency? (A*; B --)

1-Private car 96.5% 93.6% 83.7% 98.5% 97.1% 842-Taxi .7% .4% 1.2% -- .8% 13-Bus 1.3% 4.3% 7.2% 1.5% -- 84-Light rail/subway/commuter train -- -- 2.8% -- -- 15-On foot 1.5% 1.3% 5.2% -- 2.2% 395-Other -- .5% -- -- -- 1

q10 What is the second mostused means of transport used by WIC applicants and participants to get to your agency? (A*; B --)

1-Private car .8% 5.0% 5.5% 1.5% 1.3% 52-Taxi 6.3% 7.8% 5.7% 3.4% 9.9% 63-Bus 25.1% 25.3% 29.0% 1.9% 13.0% 444-Light rail/subway/commuter train .6% .1% .7% -- -- 5-On foot 43.2% 44.5% 52.5% 73.4% 47.0% 395-Other 24.0% 17.3% 6.6% 19.8% 28.8% 1

q11 How would you rate the physical security of your local agency’s location? (A n.s.; B***)

1-Very safe (No incidents) 54.3% 60.0% 54.1% 80.3% 63.8% 472-Safe (Occasional minor incidents) 42.1% 36.6% 43.8% 18.0% 32.2% 53-Unsafe (Occasional major incidents or frequent minor incide

3.6% 2.8% 1.6% 1.7% 3.1% 

4-Very unsafe (Frequent major incidents) -- .5% .5% -- .8% 

TOTAL 671 1020 599 578 625 5Note: Percentages were calculated for all cases. NOTE A applies to the RELATIONSHIP crosstab (columns 1-3): ***p<.0001; **p<.01; *p<.05; n.s. non-significant ; -- N/A for the clients served crosstab. NOTE B applies to the SIZE crosstab (columns 4-7): ***p<.0001; **p<.01; *p<.05 n.s. non-significant; -- N/A for the clients served crosstab.
 D-7 National Surv

Table 4. Characteristics of Local WIC Agency: Computers

The relationship of WIC local to State agency Clients served at the whole ag

State affiliated Local government Non-government <750 750-1,999 2,000-4

q12_a_01 Enter/access client certification information via a computer? (A--; B --)

1-Yes 94.8% 99.3% 100.0% 98.5% 94.7% 100.02-No 5.2% .7% -- 1.5% 5.3% -- 

q12_a_02 Is this computer networked to other computers in the office (i.e. a shared drive)? (A*; B --)

1-Yes 75.0% 87.5% 84.7% 76.6% 83.3% 86.62-No 15.7% 9.4% 13.6% 13.8% 11.4% 12.697-Don't know 4.2% 2.4% 1.7% 8.1% -- .8% 

q12_a_03 Is this computer networked to other agencies, clinics or the State WIC office? (A n.s.; B n.s)

1-Yes 77.8% 85.4% 87.6% 79.7% 87.2% 80.82-No 14.1% 10.0% 10.8% 11.9% 6.4% 17.197-Don't know 2.9% 3.9% 1.6% 6.9% 1.1% 2.1% 

q12_b Have internet access? (A n.s.; B n.s)

1-Yes 89.6% 93.9% 98.0% 90.1% 93.7% 93.22-No 10.4% 6.1% 2.0% 9.9% 6.3% 6.8% 

q12_c Perform hematological tests? (A n.s.; B n.s)

1-Yes 94.3% 87.1% 86.8% 93.6% 93.9% 86.92-No 5.7% 12.9% 13.2% 6.4% 6.1% 13.1

q12_d Take anthropometric measurements for weight, BMI (body mass) and height? (A--; B --)

1-Yes 100.0% 100.0% 99.5% 100.0% 100.0% 100.02-No -- -- .5% -- -- -- 

TOTAL 671 1020 599 578 625 528 Note: Percentages were calculated for all cases. NOTE A applies to the RELATIONSHIP crosstab (columns 1-3): ***p<.0001; **p<.01; *p<.05; n.s. non-significant ; -- N/A for the clients served crosstab. NOTE B applies to the SIZE crosstab (columns 4-7): ***p<.0001; **p<.01; *p<.05 n.s. non-significant; -- N/A for the clients served crosstab.
 D-8 National Surv

Table 5. Characteristics of Local WIC Agency: Services

The relationship of WIC local to State agency Clients served at the whole agency (adm

State affiliated Local government Non- government <750 750-1,999 2,000-4,500 

q13_01_01 Maternal health care: Offered by WIC Agency/Clinic itself

(A n.s.; B n.s.) 19.8% 26.8% 26.8% 30.5% 19.5% 26.5% 

q13_01_02 Maternal health care: Able to provide information

(A n.s.; B n.s.) 57.3% 70.2% 56.7% 60.2% 65.1% 64.5% 

q13_01_03 Maternal health care: Ability to make a referral

(A**; B n.s.) 58.9% 39.0% 40.4% 46.3% 41.4% 45.1% 

q13_01_04 Maternal health care: None of these

(A --; B --) 1.1% .5% -- -- 1.2% .7% 

q13_02_01 Prenatal health care: Offered by WIC Agency/Clinic itself

(A n.s.; B n.s.) 24.4% 21.6% 25.8% 29.5% 18.3% 24.7% 

q13_02_02 Prenatal health care: Able to provide information

(A*; B n.s.) 67.2% 73.6% 58.7% 66.5% 75.3% 66.8% 

q13_02_03 Prenatal health care: Ability to make a referral

(A**; B n.s.) 59.8% 41.1% 41.8% 49.4% 45.7% 43.5% 

q13_02_04 Prenatal health care: None of these

(A --; B --) -- .4% -- -- -- .7% 

q13_03_01 Children’s health care: Offered by WIC Agency/Clinic itself

(A n.s.; B n.s.) 29.9% 31.9% 29.5% 38.0% 28.1% 31.5% 

q13_03_02 Children’s health care: Able to provide information

(A*; B n.s.) 58.6% 71.8% 54.3% 62.9% 65.2% 63.1% 

q13_03_03 Children’s health care: Ability to make a referral

(A**; B n.s.) 57.6% 37.7% 41.7% 45.6% 47.5% 39.8% 

q13_03_04 Children’s health care: None of these

(A--; B --) -- .7% .6% -- -- .7% 

q13_04_01 Prevention and Screenings: Offered by WIC Agency/Clinic itself

(A***; B***) 72.2% 67.0% 44.6% 87.0% 68.1% 50.0% 

q13_04_02 Prevention and Screenings : Able to provide information

(A*; B***) 32.7% 44.7% 47.1% 21.0% 41.3% 53.3% 

q13_04_03 Prevention and Screenings : Ability to make a referral

(A n.s.; B*) 31.2% 30.9% 36.0% 23.5% 30.4% 34.9% 

q13_04_04 Prevention and Screenings : None of these

(A--; B --) -- 1.7% -- 2.1% -- .7% 

q13_05_01 Breastfeeding support: Offered by WIC Agency/Clinic itself

(A*; B --) 98.1% 97.7% 93.5% 100.0% 94.0% 96.6% 

q13_05_02 Breastfeeding support: Able to provide information

(A n.s.; B n.s.) 25.8% 28.7% 25.8% 26.6% 24.1% 30.2% 

q13_05_03 Breastfeeding support: Ability to make a referral

(A n.s.; B n.s.) 17.9% 10.4% 19.7% 13.0% 7.8% 20.4% 
 D-9 National Surv

The relationship of WIC local to State agency Clients served at the whole agency (adm

State affiliated Local government Non- government <750 750-1,999 2,000-4,500 

q13_06_01 Dietitian/nutrition services: Offered by WIC Agency/Clinic itself

(A n.s.; B n.s.) 93.8% 89.7% 90.7% 86.5% 91.4% 94.1% 

q13_06_02 Dietitian/nutrition services: Able to provide information

(A n.s.; B n.s.) 22.3% 26.3% 25.7% 28.6% 23.4% 22.2% 

q13_06_03 Dietitian/nutrition services: Ability to make a referral

(A n.s.; B n.s.) 15.8% 13.3% 20.6% 16.4% 11.5% 18.6% 

q13_06_04 Dietitian/nutrition services: None of these

(A --; B --) .6% .3% -- -- -- .8% 

q13_07_01 Mental health services: Offered by WIC Agency/Clinic itself

(A*; B n.s.) 6.4% 7.6% 17.0% 8.4% 7.3% 15.1% 

q13_07_02 Mental health services: Able to provide information

(A*; B n.s.) 64.2% 62.5% 51.9% 55.1% 63.2% 59.7% 

q13_07_03 Mental health services: Ability to make a referral

(A n.s.; B n.s.) 44.6% 42.0% 44.7% 47.3% 43.9% 38.5% 

q13_07_04 Mental health services: None of these

(A n.s.; B n.s.) 3.6% 6.5% 2.9% 6.4% 5.5% 4.8% 

q13_08_01 STD (sexually transmitted diseases): Offered by WIC Agency/Clinic itself

(A***; B**) 61.8% 47.2% 26.3% 51.6% 56.2% 43.8% 

q13_08_02 STD (sexually transmitted diseases): Able to provide information

(A n.s.; B*) 43.2% 42.1% 54.7% 39.2% 41.2% 49.9% 

q13_08_03 STD (sexually transmitted diseases): Ability to make a referral

(A n.s.; B n.s.) 33.6% 34.2% 42.7% 39.4% 32.9% 32.0% 

q13_08_04 STD (sexually transmitted diseases): None of these

(A n.s.; B --) .6% 1.0% 3.3% -- 1.6% 3.0% 

q13_09_01 Dental: Offered by WIC Agency/Clinic itself

(A n.s.; B n.s.) 15.0% 20.0% 26.0% 17.7% 15.2% 27.0% 

q13_09_02 Dental: Able to provide information

(A n.s.; B n.s.) 68.6% 68.7% 57.5% 69.7% 69.8% 60.8% 

q13_09_03 Dental: Ability to make a referral

(A n.s.; B n.s.) 42.2% 40.5% 42.4% 44.2% 47.2% 34.1% 

q13_09_04 Dental: None of these (A --; B --) 1.9% 1.7% -- -- .8% 3.6% q13_10_01 Family planning: Offered by WIC Agency/Clinic itself

(A ***; B **) 61.9% 41.8% 30.0% 54.4% 54.7% 37.4% 

q13_10_02 Family planning: Able to provide information

(A n.s.; B n.s.) 44.3% 47.6% 55.6% 41.3% 43.7% 56.0% 

q13_10_03 Family planning: Ability to make a referral

(A n.s.; B n.s.) 32.9% 36.4% 41.6% 34.0% 36.6% 35.3% 
 D-10 National Surv

The relationship of WIC local to State agency Clients served at the whole agency (adm

State affiliated Local government Non- government <750 750-1,999 2,000-4,500 

q13_10_04 Family planning: None of these

(A n.s.; B --) .6% .9% 2.2% -- 1.6% 1.5% 

q13_11_01 Child care/education (e.g., Healthy Start, Head Start): Offered by WIC Agency/Clinic itself

(A n.s.; B n.s.) 6.5% 14.0% 9.1% 17.9% 8.1% 6.6% 

q13_11_02 Child care/education (e.g., Healthy Start, Head Start): Able to provide information

(A*; B n.s.) 73.5% 72.9% 56.5% 64.9% 69.2% 72.3% 

q13_11_03 Child care/education (e.g., Healthy Start, Head Start): Ability to make a referral

(A*; B n.s.) 42.4% 39.7% 55.3% 46.2% 46.9% 38.0% 

q13_11_04 Child care/education (e.g., Healthy Start, Head Start): None of these

(A --; B --) .7% 4.5% -- 6.4% -- 1.6% 

q13_12_01 Parenting support: Offered by WIC Agency/Clinic itself

(A n.s.; B n.s.) 15.0% 17.4% 18.6% 18.7% 14.7% 20.4% 

q13_12_02 Parenting support: Able to provide information

(A*; B n.s.) 74.8% 63.4% 56.8% 57.6% 71.0% 63.1% 

q13_12_03 Parenting support: Ability to make a referral

(A n.s.; B n.s.) 38.3% 36.5% 47.7% 42.4% 38.1% 36.5% 

q13_12_04 Parenting support: None of these

(A n.s.; B n.s.) 5.2% 6.4% .9% 8.6% 2.2% 7.5% 

q13_13_01 Employment/life skills training: Offered by WIC Agency/Clinic itself

(A --; B --) -- 1.7% 4.8% -- 1.4% 4.1% 

q13_13_02 Employment/life skills training: Able to provide information

(A n.s.; B n.s.) 64.0% 66.8% 51.5% 57.3% 64.5% 60.2% 

q13_13_03 Employment/life skills training: Ability to make a referral

(A*; B n.s.) 33.0% 28.0% 45.1% 34.8% 34.2% 32.3% 

q13_13_04 Employment/life skills training: None of these

(A n.s.; B n.s.) 13.4% 15.6% 9.6% 17.2% 11.6% 13.3% 

q13_14_01 Other public assistance: Offered by WIC Agency/Clinic itself

(A n.s.; B n.s.) 2.7% 6.8% 8.9% 2.9% 5.0% 8.0% 

q13_14_02 Other public assistance: Able to provide information

(A*; B n.s.) 77.5% 71.1% 59.7% 66.7% 72.8% 72.7% 

q13_14_03 Other public assistance: Ability to make a referral

(A n.s.; B n.s.) 44.8% 38.6% 48.3% 42.6% 43.2% 41.5% 

q13_14_04 Other public assistance: None of these

(A --; B*) -- 4.7% .2% 6.4% .8% .7% 
 D-11 National Surv

The relationship of WIC local to State agency Clients served at the whole agency (adm

State affiliated Local government Non- government <750 750-1,999 2,000-4,500 

q13_15_01 Environmental health/ screening: Offered by WIC Agency/Clinic itself

(A*; B*) 28.8% 30.8% 12.3% 35.6% 30.6% 17.2% 

q13_15_02 Environmental health/ screening: Able to provide information

(A n.s.; B n.s.) 60.8% 53.2% 53.8% 56.7% 54.2% 55.4% 

q13_15_03 Environmental health/ screening: Ability to make a referral

(A n.s.; B n.s.) 35.4% 31.5% 43.0% 31.5% 40.0% 33.9% 

q13_15_04 Environmental health/ creening: None of these

(A n.s.; B n.s.) 9.5% 8.8% 6.0% 6.4% 5.8% 11.9% 

q13_16_01 Substance abuse counseling/treatment: Offered by WIC Agency/Clinic itself

(A*; B n.s.) 3.9% 9.1% 11.7% 7.0% 3.5% 10.0% 

q13_16_02 Substance abuse counseling/treatment: Able to provide information

(A n.s.; B n.s.) 72.0% 67.9% 56.0% 58.2% 71.7% 67.1% 

q13_16_03 Substance abuse counseling/treatment: Ability to make a referral

(A n.s.; B n.s.) 49.1% 43.9% 48.7% 48.9% 52.3% 39.2% 

q13_16_04 Substance abuse counseling/treatment: None of these

(A n.s.; B --) 2.1% 4.4% .4% 6.4% -- 4.1% 

q13_17_01 Smoking cessation: Offered by WIC Agency/Clinic itself

(A n.s.; B n.s.) 23.0% 29.4% 18.8% 23.7% 23.3% 28.4% 

q13_17_02 Smoking cessation: Able to provide information

(A n.s.; B n.s.) 73.3% 67.0% 55.8% 63.2% 69.5% 63.7% 

q13_17_03 Smoking cessation: Ability to make a referral

(A**; B n.s.) 42.6% 33.3% 48.1% 33.7% 43.1% 40.1% 

q13_17_04 Smoking cessation: None of these

(A --; B --) .8% 1.6% -- -- 1.2% 2.7% 

q13_18_01 Violence Protection/Prevention (women): Offered by WIC Agency/Clinic itself

(A n.s.; B --) 2.3% 2.2% 5.4% -- 1.0% 6.5% 

q13_18_02 Violence Protection/Prevention (women): Able to provide information

(A*; B n.s.) 77.3% 72.7% 59.6% 68.2% 72.3% 71.6% 

q13_18_03 Violence Protection/Prevention (women): Ability to make a referral

(A n.s.; B n.s.) 46.9% 40.4% 48.7% 42.6% 49.5% 39.3% 

q13_18_04 Violence Protection/Prevention (women): None of these

(A n.s.; B n.s.) 2.0% 4.7% 2.0% 6.4% 1.6% 4.0% 
 D-12 National Surv

The relationship of WIC local to State agency Clients served at the whole agency (adm

State affiliated Local government Non- government <750 750-1,999 2,000-4,500 

q13_19_01 Violence Protection/Prevention (children): Offered by WIC Agency/Clinic itself

(A n.s.; B --) 1.2% 2.8% 3.8% -- 1.1% 4.5% 

q13_19_02 Violence Protection/Prevention (children): Able to provide information

(A*; B n.s.) 75.8% 71.3% 56.9% 65.7% 71.3% 69.4% 

q13_19_03 Violence Protection/Prevention (children): Ability to make a referral

(A n.s.; B n.s.) 48.9% 42.0% 50.1% 42.6% 51.7% 41.8% 

q13_19_04 Violence Protection/Prevention (children): None of these

(A n.s.; B n.s.) 2.0% 4.7% 2.0% 6.4% 1.6% 4.0% 

q13_95_01 OTHER: SPECIFY: Offered by WIC Agency/Clinic itself

(A*; B --) .2% 4.1% 2.8% 2.4% 3.4% -- 

q13_95_02 OTHER: SPECIFY: Able to provide information

(A n.s.; B n.s.) 1.1% 3.9% 2.7% 2.4% 3.5% 1.6% 

q13_95_03 OTHER: SPECIFY: Ability to make a referral

(A**; B --) .3% 3.5% .5% -- 2.3% .8% 

q13_95_04 OTHER: SPECIFY: None of these

(A n.s.; B n.s.) 98.4% 93.0% 95.1% 97.6% 93.2% 98.4% 

TOTAL 671 1020 599 578 625 528 Note: Percentages were calculated for all cases. NOTE A applies to the RELATIONSHIP crosstab (columns 1-3): ***p<.0001; **p<.01; *p<.05; n.s. non-significant ; -- N/A for the clients served crosstab. NOTE B applies to the SIZE crosstab (columns 4-7): ***p<.0001; **p<.01; *p<.05 n.s. non-significant; -- N/A for the clients served crosstab.
 D-13 National Surv

Table 6. Characteristics of Local WIC Agency: Referrals

The relationship of WIC local to State agency Clients served at the whole agency (adm

State affiliated Local government Non- government <750 750-1,999 2,000-4,500 

q13a_01_01 Maternal Health Care: Referral sheet (A n.s.; B n.s.)

0-No 30.0% 36.9% 36.9% 28.7% 34.7% 41.6% 1-Yes 70.0% 63.1% 63.1% 71.3% 65.3% 58.4% 

q13a_01_02 Maternal Health Care: Org. name is given out (A n.s.; B n.s.)

0-No 59.6% 56.6% 51.3% 54.1% 60.7% 58.0% 1-Yes 40.4% 43.4% 48.7% 45.9% 39.3% 42.0% 

q13a_01_03 Maternal Health Care: Org. is notified (A n.s.; B n.s.)

0-No 78.0% 90.1% 91.0% 86.0% 82.0% 85.5% 1-Yes 22.0% 9.9% 9.0% 14.0% 18.0% 14.5% 

q13a_01_04 Maternal Health Care: Other (A n.s.; B n.s.)

0-No 95.0% 88.2% 88.0% 100.0% 90.0% 81.8% 1-Yes 5.0% 11.8% 12.0% -- 10.0% 18.2% 

q13a_02_01 Prenatal Health Care: Referral sheet (A n.s.; B n.s.)

0-No 29.9% 39.6% 32.9% 33.2% 30.3% 46.2% 1-Yes 70.1% 60.4% 67.1% 66.8% 69.7% 53.8% 

q13a_02_02 Prenatal Health Care: Org. name is given out (A n.s.; B n.s.)

0-No 56.7% 51.9% 53.6% 50.7% 62.4% 48.7% 1-Yes 43.3% 48.1% 46.4% 49.3% 37.6% 51.3% 

q13a_02_03 Prenatal Health Care: Org. is notified (A n.s.; B n.s.)

0-No 76.2% 89.3% 87.8% 86.9% 78.2% 79.5% 1-Yes 23.8% 10.7% 12.2% 13.1% 21.8% 20.5% 

q13a_02_04 Prenatal Health Care: Other (A n.s.; B n.s.)

0-No 96.1% 87.8% 89.8% 100.0% 90.9% 82.5% 1-Yes 3.9% 12.2% 10.2% -- 9.1% 17.5% 

q13a_03_01 Children's Health Care: Referral sheet (A n.s.; B n.s.)

0-No 20.9% 37.9% 33.2% 23.4% 25.3% 47.6% 1-Yes 79.1% 62.1% 66.8% 76.6% 74.7% 52.4% 

q13a_03_02 Children's Health Care: Org. name is given out (A n.s.; B n.s.)

0-No 64.8% 51.0% 51.9% 57.0% 66.7% 51.0% 1-Yes 35.2% 49.0% 48.1% 43.0% 33.3% 49.0% 

q13a_03_03 Children's Health Care: Org. is notified (A n.s.; B n.s.)

0-No 77.7% 87.3% 82.7% 80.2% 81.8% 77.9% 1-Yes 22.3% 12.7% 17.3% 19.8% 18.2% 22.1% 

q13a_03_04 Children's Health Care: Other (A n.s.; B n.s.)

0-No 97.0% 90.0% 95.0% 100.0% 95.3% 85.1% 1-Yes 3.0% 10.0% 5.0% -- 4.7% 14.9% 

q13a_04_01 Prevention and Screenings: Referral sheet (A n.s.; B n.s.)

0-No 36.9% 49.1% 30.4% 25.9% 49.0% 47.9% 1-Yes 63.1% 50.9% 69.6% 74.1% 51.0% 52.1% 

q13a_04_02 Prevention and Screenings: Org. name is given out (A n.s.; B n.s.)

0-No 48.3% 36.7% 54.4% 36.4% 44.7% 52.5% 1-Yes 51.7% 63.3% 45.6% 63.6% 55.3% 47.5% 

q13a_04_03 Prevention and Screenings: Org. is notified (A n.s.; B n.s.)

0-No 93.4% 85.6% 86.9% 82.7% 96.1% 83.4% 1-Yes 6.6% 14.4% 13.1% 17.3% 3.9% 16.6% 

q13a_04_04 Prevention and Screenings: Other (A n.s.; B n.s.)

0-No 90.5% 86.5% 87.7% 100.0% 89.7% 75.4% 1-Yes 9.5% 13.5% 12.3% -- 10.3% 24.6% 

q13a_05_01 Breastfeeding Support: Referral sheet (A n.s.; B n.s.)

0-No 33.4% 34.4% 35.8% 28.9% 29.4% 39.3% 1-Yes 66.6% 65.6% 64.2% 71.1% 70.6% 60.7% 
 D-14 National Surv

The relationship of WIC local to State agency Clients served at the whole agency (adm

State affiliated Local government Non- government <750 750-1,999 2,000-4,500 

q13a_05_02 Breastfeeding Support: Org. name is given out (A n.s.; B n.s.)

0-No 35.3% 35.4% 50.7% 37.2% 29.5% 64.1% 1-Yes 64.7% 64.6% 49.3% 62.8% 70.5% 35.9% 

q13a_05_03 Breastfeeding Support: Org. is notified (A n.s.; B n.s.)

0-No 80.3% 75.0% 95.6% 88.2% 84.7% 84.1% 1-Yes 19.7% 25.0% 4.4% 11.8% 15.3% 15.9% 

q13a_05_04 Breastfeeding Support: Other (A n.s.; B n.s.)

0-No 92.7% 89.1% 81.1% 100.0% 100.0% 70.0% 1-Yes 7.3% 10.9% 18.9% -- -- 30.0% 

q13a_06_01 Dietitian/Nutrition Services: Referral sheet (A n.s.; B n.s.)

0-No 25.7% 27.9% 27.4% 19.0% 29.3% 29.0% 1-Yes 74.3% 72.1% 72.6% 81.0% 70.7% 71.0% 

q13a_06_02 Dietitian/Nutrition Services: Org. name is given out (A n.s.; B n.s.)

0-No 40.8% 41.3% 53.3% 29.3% 53.2% 63.7% 1-Yes 59.2% 58.7% 46.7% 70.7% 46.8% 36.3% 

q13a_06_03 Dietitian/Nutrition Services: Org. is notified (A n.s.; B n.s.)

0-No 83.2% 81.3% 96.6% 90.7% 89.6% 82.2% 1-Yes 16.8% 18.7% 3.4% 9.3% 10.4% 17.8% 

q13a_06_04 Dietitian/Nutrition Services: Other (A n.s.; B n.s.)

0-No 96.4% 93.8% 85.7% 100.0% 100.0% 77.3% 1-Yes 3.6% 6.2% 14.3% -- -- 22.7% 

q13a_07_01 Mental Health Services: Referral sheet (A n.s.; B n.s.)

0-No 34.7% 43.1% 40.8% 33.9% 36.0% 56.1% 1-Yes 65.3% 56.9% 59.2% 66.1% 64.0% 43.9% 

q13a_07_02 Mental Health Services: Org. name is given out (A n.s.; B n.s.)

0-No 52.4% 56.0% 57.5% 50.9% 52.8% 61.5% 1-Yes 47.6% 44.0% 42.5% 49.1% 47.2% 38.5% 

q13a_07_03 Mental Health Services: Org. is notified (A n.s.; B n.s.)

0-No 97.1% 88.8% 87.9% 86.7% 91.3% 89.7% 1-Yes 2.9% 11.2% 12.1% 13.3% 8.7% 10.3% 

q13a_07_04 Mental Health Services: Other (A n.s.; B n.s.)

0-No 90.7% 90.8% 88.4% 100.0% 92.4% 78.6% 1-Yes 9.3% 9.2% 11.6% -- 7.6% 21.4% 

q13a_08_01 STD: Referral sheet (A***; B n.s.)

0-No 23.0% 59.2% 41.1% 42.6% 42.3% 56.3% 1-Yes 77.0% 40.8% 58.9% 57.4% 57.7% 43.7% 

q13a_08_02 STD: Org. name is given out (A n.s.; B n.s.)

0-No 49.6% 46.3% 66.4% 58.5% 47.9% 48.8% 1-Yes 50.4% 53.7% 33.6% 41.5% 52.1% 51.2% 

q13a_08_03 STD: Org. is notified (A n.s.; B n.s.)

0-No 85.9% 92.1% 100.0% 91.7% 91.9% 93.0% 1-Yes 14.1% 7.9% -- 8.3% 8.1% 7.0% 

q13a_08_04 STD: Other (A n.s.; B n.s.)

0-No 88.3% 78.0% 78.0% 74.9% 84.1% 76.3% 1-Yes 11.7% 22.0% 22.0% 25.1% 15.9% 23.7% 

q13a_09_01 Dental: Referral sheet (A n.s.; B n.s.)

0-No 33.9% 40.9% 35.0% 36.5% 31.7% 46.2% 1-Yes 66.1% 59.1% 65.0% 63.5% 68.3% 53.8% 

q13a_09_02 Dental: Org. name is given out (A n.s.; B n.s.)

0-No 54.4% 58.6% 65.9% 60.9% 68.3% 53.0% 1-Yes 45.6% 41.4% 34.1% 39.1% 31.7% 47.0% 

q13a_09_03 Dental: Org. is notified (A n.s.; B n.s.)

0-No 99.3% 94.3% 94.4% 100.0% 90.7% 95.5% 1-Yes .7% 5.7% 5.6% -- 9.3% 4.5% 
 D-15 National Surv

The relationship of WIC local to State agency Clients served at the whole agency (adm

State affiliated Local government Non- government <750 750-1,999 2,000-4,500 

q13a_09_04 Dental: Other (A n.s.; B n.s.)

0-No 91.7% 85.2% 88.0% 85.5% 91.1% 82.2% 1-Yes 8.3% 14.8% 12.0% 14.5% 8.9% 17.8% 

q13a_10_01 Family Planning: Referral sheet (A*; B n.s.)

0-No 22.1% 48.4% 39.1% 36.6% 35.5% 51.1% 1-Yes 77.9% 51.6% 60.9% 63.4% 64.5% 48.9% 

q13a_10_02 Family Planning: Org. name is given out (A n.s.; B n.s.)

0-No 45.3% 45.9% 58.6% 47.0% 51.9% 48.9% 1-Yes 54.7% 54.1% 41.4% 53.0% 48.1% 51.1% 

q13a_10_03 Family Planning: Org. is notified (A n.s.; B n.s.)

0-No 91.2% 94.3% 96.5% 95.5% 92.6% 91.5% 1-Yes 8.8% 5.7% 3.5% 4.5% 7.4% 8.5% 

q13a_10_04 Family Planning: Other (A n.s.; B n.s.)

0-No 89.5% 81.9% 88.4% 81.2% 88.5% 78.6% 1-Yes 10.5% 18.1% 11.6% 18.8% 11.5% 21.4% 

q13a_11_01 Child Care/Education: Referral sheet (A n.s.; B n.s.)

0-No 43.1% 40.6% 38.4% 38.1% 40.6% 49.2% 1-Yes 56.9% 59.4% 61.6% 61.9% 59.4% 50.8% 

q13a_11_02 Child Care/Education: Org. name is given out (A n.s.; B n.s.)

0-No 52.9% 43.3% 50.3% 44.3% 54.4% 42.6% 1-Yes 47.1% 56.7% 49.7% 55.7% 45.6% 57.4% 

q13a_11_03 Child Care/Education: Org. is notified (A n.s.; B n.s.)

0-No 93.5% 94.6% 87.6% 94.5% 91.5% 87.4% 1-Yes 6.5% 5.4% 12.4% 5.5% 8.5% 12.6% 

q13a_11_04 Child Care/Education: Other (A n.s.; B n.s.)

0-No 89.8% 95.4% 91.7% 96.3% 95.8% 87.6% 1-Yes 10.2% 4.6% 8.3% 3.7% 4.2% 12.4% 

q13a_12_01 Parenting Support: Referral sheet (A n.s.; B n.s.)

0-No 45.9% 46.6% 48.1% 47.2% 49.8% 56.5% 1-Yes 54.1% 53.4% 51.9% 52.8% 50.2% 43.5% 

q13a_12_02 Parenting Support: Org. name is given out (A n.s.; B n.s.)

0-No 48.2% 45.8% 46.0% 41.6% 41.2% 48.2% 1-Yes 51.8% 54.2% 54.0% 58.4% 58.8% 51.8% 

q13a_12_03 Parenting Support: Org. is notified (A n.s.; B n.s.)

0-No 94.5% 92.1% 91.9% 100.0% 87.8% 87.3% 1-Yes 5.5% 7.9% 8.1% -- 12.2% 12.7% 

q13a_12_04 Parenting Support: Other (A n.s.; B n.s.)

0-No 93.6% 91.6% 88.5% 93.9% 97.7% 82.6% 1-Yes 6.4% 8.4% 11.5% 6.1% 2.3% 17.4% 

q13a_13_01 Employment/Life Skills Training: Referral sheet (A n.s.; B n.s.)

0-No 57.3% 45.8% 47.4% 49.0% 52.6% 58.6% 1-Yes 42.7% 54.2% 52.6% 51.0% 47.4% 41.4% 

q13a_13_02 Employment/Life Skills Training: Org. name is given out (A n.s.; B n.s.)

0-No 49.3% 56.2% 49.6% 43.3% 52.3% 51.9% 1-Yes 50.7% 43.8% 50.4% 56.7% 47.7% 48.1% 

q13a_13_03 Employment/Life Skills Training: Org. is notified (A n.s.; B n.s.)

0-No 100.0% 96.0% 100.0% 100.0% 97.4% 97.5% 1-Yes -- 4.0% -- -- 2.6% 2.5% 

q13a_13_04 Employment/Life Skills Training: Other (A n.s.; B n.s.)

0-No 83.5% 92.5% 85.4% 95.0% 84.8% 80.6% 1-Yes 16.5% 7.5% 14.6% 5.0% 15.2% 19.4% 

q13a_14_01 Other Public Assistance: Referral sheet (A n.s.; B n.s.)

0-No 38.9% 41.3% 49.7% 33.7% 44.2% 53.8% 1-Yes 61.1% 58.7% 50.3% 66.3% 55.8% 46.2% 
 D-16 National Surv

The relationship of WIC local to State agency Clients served at the whole agency (adm

State affiliated Local government Non- government <750 750-1,999 2,000-4,500 

q13a_14_02 Other Public Assistance: Org. name is given out (A n.s.; B n.s.)

0-No 57.2% 44.6% 49.9% 38.9% 56.3% 46.2% 1-Yes 42.8% 55.4% 50.1% 61.1% 43.7% 53.8% 

q13a_14_03 Other Public (A n.s.; B n.s.)Assistance: Org. is notified (A n.s.; B n.s.)

0-No 97.0% 95.5% 89.8% 94.1% 95.8% 90.0% 1-Yes 3.0% 4.5% 10.2% 5.9% 4.2% 10.0% 

q13a_14_04 Other Public Assistance: Other (A n.s.; B n.s.)

0-No 86.8% 94.2% 87.7% 95.9% 95.5% 83.2% 1-Yes 13.2% 5.8% 12.3% 4.1% 4.5% 16.8% 

q13a_15_01 Environmental Health/Screening: Referral sheet (A n.s.; B n.s.)

0-No 49.5% 43.8% 44.9% 37.2% 49.5% 60.7% 1-Yes 50.5% 56.2% 55.1% 62.8% 50.5% 39.3% 

q13a_15_02 Environmental Health/Screening: Org. name is given out (A n.s.; B*)

0-No 45.3% 39.8% 50.9% 26.5% 41.9% 52.1% 1-Yes 54.7% 60.2% 49.1% 73.5% 58.1% 47.9% 

q13a_15_03 Environmental Health/Screening: Org. is notified (A n.s.; B n.s.)

0-No 100.0% 90.8% 98.4% 100.0% 91.3% 97.8% 1-Yes -- 9.2% 1.6% -- 8.7% 2.2% 

q13a_15_04 Environmental Health/Screening: Other (A n.s.; B n.s.)

0-No 82.3% 90.5% 87.8% 94.5% 89.8% 76.1% 1-Yes 17.7% 9.5% 12.2% 5.5% 10.2% 23.9% 

q13a_16_01 Substance Abuse Counseling/Treatment: Referral sheet (A n.s.; B n.s.)

0-No 43.0% 44.3% 36.4% 35.4% 41.0% 56.2% 1-Yes 57.0% 55.7% 63.6% 64.6% 59.0% 43.8% 

q13a_16_02 Substance Abuse Counseling/Treatment: Org. name is given out (A n.s.; B n.s.)

0-No 47.8% 41.1% 61.6% 37.7% 56.8% 49.9% 1-Yes 52.2% 58.9% 38.4% 62.3% 43.2% 50.1% 

q13a_16_03 Substance Abuse Counseling/Treatment: Org. is notified (A***; B n.s.)

0-No 95.9% 88.0% 99.2% 96.9% 90.6% 92.3% 1-Yes 4.1% 12.0% .8% 3.1% 9.4% 7.7% 

q13a_16_04 Substance Abuse Counseling/Treatment: Other (A n.s.; B n.s.)

0-No 90.7% 93.5% 87.5% 100.0% 92.0% 77.7% 1-Yes 9.3% 6.5% 12.5% -- 8.0% 22.3% 

q13a_17_01 Smoking Cessation: Referral sheet (A n.s.; B n.s.)

0-No 30.3% 37.7% 36.6% 26.5% 32.0% 43.4% 1-Yes 69.7% 62.3% 63.4% 73.5% 68.0% 56.6% 

q13a_17_02 Smoking Cessation: Org. name is given out (A n.s.; B n.s.)

0-No 53.7% 44.8% 54.0% 55.9% 54.3% 45.3% 1-Yes 46.3% 55.2% 46.0% 44.1% 45.7% 54.7% 

q13a_17_03 Smoking Cessation: Org. is notified (A n.s.; B n.s.)

0-No 96.1% 91.1% 92.3% 95.5% 98.0% 83.6% 1-Yes 3.9% 8.9% 7.7% 4.5% 2.0% 16.4% 

q13a_17_04 Smoking Cessation: Other (A n.s.; B n.s.)

0-No 92.5% 92.9% 91.7% 100.0% 90.3% 88.1% 1-Yes 7.5% 7.1% 8.3% -- 9.7% 11.9% 

q13a_18_01 Violence Protection/Prevention (Women): Referral sheet (A n.s.; B n.s.)

0-No 55.6% 48.1% 49.3% 48.7% 50.5% 61.9% 1-Yes 44.4% 51.9% 50.7% 51.3% 49.5% 38.1% 
 D-17 National Surv

The relationship of WIC local to State agency Clients served at the whole agency (adm

State affiliated Local government Non- government <750 750-1,999 2,000-4,500 

q13a_18_02 Violence Protection/Prevention (Women): Org. name is given out (A n.s.; B n.s.)

0-No 50.0% 51.6% 42.7% 45.7% 46.4% 50.1% 1-Yes 50.0% 48.4% 57.3% 54.3% 53.6% 49.9% 

q13a_18_03 Violence Protection/Prevention (Women): Org. is notified (A n.s.; B n.s.)

0-No 75.4% 74.9% 81.4% 76.0% 77.3% 79.3% 1-Yes 24.6% 25.1% 18.6% 24.0% 22.7% 20.7% 

q13a_18_04 Violence Protection/Prevention (Women): Other (A n.s.; B n.s.)

0-No 94.6% 92.3% 86.4% 100.0% 91.7% 81.8% 1-Yes 5.4% 7.7% 13.6% -- 8.3% 18.2% 

q13a_19_01 Violence Protection/Prevention (Children): Referral sheet (A n.s.; B n.s.)

0-No 62.7% 50.4% 49.9% 52.6% 54.8% 64.1% 1-Yes 37.3% 49.6% 50.1% 47.4% 45.2% 35.9% 

q13a_19_02 Violence Protection/Prevention (Children): Org. name is given out (A n.s.; B n.s.)

0-No 53.6% 55.2% 47.7% 45.7% 53.1% 57.2% 1-Yes 46.4% 44.8% 52.3% 54.3% 46.9% 42.8% 

q13a_19_03 Violence Protection/Prevention (Children): Org. is notified (A n.s.; B n.s.)

0-No 55.4% 68.7% 72.8% 67.7% 63.8% 66.9% 1-Yes 44.6% 31.3% 27.2% 32.3% 36.2% 33.1% 

q13a_19_04 Violence Protection/Prevention (Children): Other (A n.s.; B n.s.)

0-No 94.8% 91.5% 88.3% 100.0% 90.6% 85.0% 1-Yes 5.2% 8.5% 11.7% -- 9.4% 15.0% 

q13a_95_01 Other Specify: Referral sheet (A n.s.; B n.s.)

0-No 47.1% 16.9% 57.2% -- -- -- 1-Yes 52.9% 83.1% 42.8% -- 100.0% 100.0% 

q13a_95_02 Other Specify: Org. name is given out (A n.s.; B n.s.)

0-No 52.9% 17.4% 57.2% -- 32.2% 100.0% 1-Yes 47.1% 82.6% 42.8% -- 67.8% -- 

q13a_95_03 Other Specify: Org. is notified (A n.s.; B n.s.)

0-No 85.2% 54.6% 82.2% -- 32.2% 100.0% 1-Yes 14.8% 45.4% 17.8% -- 67.8% -- 

q13a_95_04 Other Specify: Other (A n.s.; B n.s.)

0-No 100.0% 79.2% 60.7% -- 100.0% -- 1-Yes -- 20.8% 39.3% -- -- 100.0% 

TOTAL 671 1020 599 578 625 528 Note: Percentages were calculated for cases with referrals. NOTE A applies to the RELATIONSHIP crosstab (columns 1-3): ***p<.0001; **p<.01; *p<.05; n.s. non-significant ; -- N/A for the clients served crosstab. NOTE B applies to the SIZE crosstab (columns 4-7): ***p<.0001; **p<.01; *p<.05 n.s. non-significant; -- N/A for the clients served crosstab.
 D-18 National Surv

Table 7. WIC Agency Procedures: Identification

The relationship of WIC local to State agency Clients served at the whole age

State affiliated Local government Non- government <750 750-1,999 2,000-4,5

q14_1 Drivers license, State ID (A n.s.; B***) 79.3% 66.2% 75.0% 55.0% 73.1% 82.8% q14_2 Current utility/tax bill with address on it

(A n.s.; B n.s.) 96.3% 99.1% 96.4% 98.3% 98.1% 96.7% 

q14_3 Written statement from reliable third party

(A n.s.; B*) 69.1% 63.3% 59.3% 55.9% 77.6% 62.5% 

q14_4 Checkbook, Bank Statement

(A n.s.; B n.s.) 35.1% 32.6% 30.7% 22.9% 36.8% 30.8% 

q14_5 Rent receipt, mortgage receipt or lease

(A n.s.; B n.s.) 90.1% 91.3% 93.8% 90.2% 90.7% 91.4% 

q14_6 Other: SPECIFY (A n.s.; B n.s.) 22.7% 13.3% 16.6% 13.2% 15.7% 21.1% q14_7 Other: SPECIFY (A n.s.; B n.s.) 15.4% 11.6% 13.6% 9.4% 15.7% 17.7% q14_8 Other: SPECIFY (A n.s.; B n.s.) 7.5% 8.4% 8.5% 1.7% 10.2% 9.9% q14_9 Other: SPECIFY (A*; B*) 12.8% 5.8% 3.4% 1.7% 13.5% 7.0% q14_10 Medicaid or health insurance card

(A n.s.; B n.s.) 19.5% 17.0% 10.4% 12.3% 19.9% 17.6% 

q14_11 Paystub, Paycheck, SSI check, unemployment check

(A n.s.; B n.s.) 13.5% 7.5% 14.4% 3.8% 13.6% 14.4% 

q14_12 Other mail with name and address on it

(A n.s.; B n.s.) 11.3% 19.2% 13.2% 10.6% 21.1% 9.2% 

TOTAL 671 1020 599 578 625 528 Note: Percentages were calculated for all cases. NOTE A applies to the RELATIONSHIP crosstab (columns 1-3): ***p<.0001; **p<.01; *p<.05; n.s. non-significant ; -- N/A for the clients served crosstab. NOTE B applies to the SIZE crosstab (columns 4-7): ***p<.0001; **p<.01; *p<.05 n.s. non-significant; -- N/A for the clients served crosstab.
 D-19 National Surv

Table 8. WIC Agency Procedures: Certifications

The relationship of WIC local to State agency Clients served at the whole 

State affiliated Local government Non- government <750 750-1,999 2,00

q15_1 The agency keeps a PHYSICAL copy of documents proving adjunctive or automatic eligibility for applicants (A n.s.; B n.s.)

30.5% 30.0% 19.9% 22.9% 34.9% 26

q15_2 The agency keeps an ELECTRONIC copy of documents proving adjunctive or automatic eligibility for applicants (A*; B***)

22.4% 5.9% 7.3% 16.4% 14.4% 9

q15_3 The agency DOES NOT keep a copy of documents proving adjunctive or automatic eligibility for applicants (A**; B n.s.)

49.3% 65.5% 75.5% 65.1% 52.9% 65

q16 When does the start-date for a certification occur? (A n.s.; B n.s.)

1-When the WIC applicant first comes into the clinic 24.8% 19.3% 25.6% 22.5% 21.5% 22-When the WIC application is filled out 13.9% 12.3% 9.0% 11.0% 9.8% 123-When the WIC application is filled out and all supporting in 61.3% 68.4% 65.2% 66.5% 68.7% 65

q17 What discretion, if any, does the state use or grant to local agencies regarding certification periods? (A n.s.; B n.s.)

No additional discretion is given 75.5% 70.0% 66.4% 65.2% 72.5% 72One month extensions 10.0% 10.9% 18.4% 5.1% 15.9% 13Other 14.5% 19.1% 13.8% 29.8% 10.5% 14

TOTAL 671 1020 599 578 625 5Note: Percentages were calculated for all cases. NOTE A applies to the RELATIONSHIP crosstab (columns 1-3): ***p<.0001; **p<.01; *p<.05; n.s. non-significant ; -- N/A for the clients served crosstab. NOTE B applies to the SIZE crosstab (columns 4-7): ***p<.0001; **p<.01; *p<.05 n.s. non-significant; -- N/A for the clients served crosstab.Table 9. WIC Agency Procedures: Certifications

The relationship of WIC local to State agency Clients served at the whole age

State affiliated Local government Non- government <750 750-1,999 2,000-4,5

q18 Do certifications have to take place in person? (A n.s.; B n.s.)

1-Yes 97.3% 94.2% 89.9% 93.7% 94.4% 93.8% 2-No 2.7% 5.8% 8.7% 6.3% 4.5% 6.2% 

q19_1 Phone (A n.s.; B --) .5% 2.6% 2.7% -- 2.4% 2.2% q19_2 Mail (A n.s.; B --) 1.0% .5% 3.2% 1.8% 2.4% -- q19_3 Fax (A --; B --) -- .5% 3.2% 1.8% 1.4% -- q19_4 Other: SPECIFY(A n.s.; B n.s.) 1.5% 3.4% 6.8% 6.3% 1.0% 4.9% TOTAL 671 1020 599 578 625 528 Note: Percentages were calculated for all cases. NOTE A applies to the RELATIONSHIP crosstab (columns 1-3): ***p<.0001; **p<.01; *p<.05; n.s. non-significant ; -- N/A for the clients served crosstab. NOTE B applies to the SIZE crosstab (columns 4-7): ***p<.0001; **p<.01; *p<.05 n.s. non-significant; -- N/A for the clients served crosstab.
 D-20 National Surv

Table 10. WIC Agency Procedures: Temporary Certifications

The relationship of WIC local to State agency Clients served at the whole 

State affiliated Local government Non- government <750 750-1,999 2,00

q20 Approximately what percentage of WIC applicants are given temporary certification, that is, 30 days of food instruments while the validity of their application for WIC certification is being established? (A--; B--)

0% 38.2% 29.9% 33.2% 26.6% 37.7% 301-10% 41.2% 49.1% 48.1% 55.8% 44.6% 4811-20% 4.7% 8.2% 9.9% 8.1% 5.4% 821-30% 5.2% 6.8% 6.1% 1.5% 4.8% 831-40% 2.5% 4.3% .5% 2.1% 4.0% 241-50% 3.9% .8% .4% 3.3% 1.1% 51-60% 1.7% .1% -- -- 1.3% 61-70% -- -- -- -- -- 71-80% -- .3% .3% -- -- 81-90% .3% -- -- -- -- 91-100% 2.2% .5% .2% 2.6% -- 

q20 Approximately what percentage of WIC applicants are given temporary certification, that is, 30 days of food instruments while the validity of their application for WIC certification is being established? (A n.s.; B n.s.)

2.3 2.1 2.0 2.3 2.0 

(2.0) (1.3) (1.1) (1.8) (1.2) (

N=671 N=1020 N=591 N=578 N=618 N

q20a How confident are you in the range above? (A n.s.; B n.s.)

1-Very confident 71.8% 66.1% 59.4% 77.8% 66.3% 592-Somewhat confident 19.6% 24.1% 28.6% 15.6% 25.2% 253-Not very confident (i.e. a lot of guesswork involved) 8.7% 9.8% 10.7% 6.6% 7.4% 14

TOTAL 671 1020 599 578 625 5Note 1: Percentages and averages were calculated for all cases. Note 2: Standard deviations for the averages are in parenthesis. NOTE A applies to the RELATIONSHIP crosstab (columns 1-3): ***p<.0001; **p<.01; *p<.05; n.s. non-significant ; -- N/A for the clients served crosstab. NOTE B applies to the SIZE crosstab (columns 4-7): ***p<.0001; **p<.01; *p<.05 n.s. non-significant; -- N/A for the clients served crosstab.
 D-21 National Surv

Table 11. WIC Agency Procedures: Actions Designated Proxies Allowed to Do on Behalf of the WIC Participants

The relationship of WIC local to State agency Clients served at the whole age

State affiliated Local government Non- government <750 750-1,999 2,000-4,5

q21_1 Get certification for the WIC applicant

(A***; B n.s.) 63.0% 39.4% 31.5% 45.6% 49.8% 48.5% 

q21_2 Pick up food instruments (A n.s.; B n.s.) 97.2% 98.7% 96.7% 100.0% 93.4% 98.9% q21_3 Attend educational sessions (A n.s.; B n.s.) 88.2% 75.5% 81.1% 70.2% 87.2% 82.6% q21_6 Use food instruments at store (A n.s.; B n.s.) 14.2% 19.5% 17.1% 20.2% 17.7% 14.2% q21_4 Other: PLEASE SPECIFY (A --; B n.s.) -- 4.1% 4.1% 2.4% 1.0% 4.5% q21_5 Not Applicable. State does not allow proxies

(A n.s.; B --) 1.0% .5% 1.6% -- 2.6% 1.1% 

TOTAL 671 1020 599 578 625 528 Note: Percentages were calculated for all cases. NOTE A applies to the RELATIONSHIP crosstab (columns 1-3): ***p<.0001; **p<.01; *p<.05; n.s. non-significant ; -- N/A for the clients served crosstab. NOTE B applies to the SIZE crosstab (columns 4-7): ***p<.0001; **p<.01; *p<.05 n.s. non-significant; -- N/A for the clients served crosstab.Table 12. WIC Agency Procedures: Controls To Ensure That a WIC Applicant Is Not Already Participating In WIC At a Different Location

The relationship of WIC local to State agency Clients served at the whole age

State affiliated Local government Non- government <750 750-1,999 2,000-4,5

q22_1 Applicant must show identification

(A n.s.; B n.s.) 82.6% 72.3% 74.8% 70.8% 81.3% 72.5% 

q22_2 Applicant must submit proof of current residence

(A n.s.; B n.s.) 82.1% 71.8% 74.7% 76.3% 79.3% 71.5% 

q22_3 Computer checks system based on applicant information

(A n.s.; B**) 73.4% 85.5% 87.7% 75.7% 78.4% 85.6% 

q22_4 Computer checks system based on Social Security number

(A n.s.; B n.s.) 29.4% 26.8% 16.0% 17.5% 29.9% 19.5% 

q22_5 Other procedure: PLEASE DESCRIBE

(A***; B n.s.) 25.1% 9.6% 17.5% 9.8% 18.1% 20.1% 

TOTAL 671 1020 599 578 625 528 Note: Percentages were calculated for all cases. NOTE A applies to the RELATIONSHIP crosstab (columns 1-3): ***p<.0001; **p<.01; *p<.05; n.s. non-significant ; -- N/A for the clients served crosstab. NOTE B applies to the SIZE crosstab (columns 4-7): ***p<.0001; **p<.01; *p<.05 n.s. non-significant; -- N/A for the clients served crosstab.
 D-22 National Surv

Table 13. WIC Agency Procedures: Denied Certifications

The relationship of WIC local to State agency Clients served at the whole 

State affiliated Local government Non- government <750 750-1,999 2,00

q23 Of applicants new to WIC, what percentage is denied certification? (A--; B--)

1-<=10% 96.7% 95.9% 96.8% 94.9% 97.8% 972-11-20% 3.3% 2.9% 1.4% 3.5% 1.1% 23-21-30% -- 1.2% -- 1.6% -- 10-91-100% -- -- .5% -- -- 

q23a How confident are you in the range above? (A n.s.; B n.s.)

1-Very confident 86.1% 84.9% 80.9% 85.1% 85.6% 862-Somewhat confident 11.9% 12.5% 16.3% 13.4% 12.3% 103-Not very confident (i.e. a lot of guesswork involved) 2.0% 2.6% 1.3% 1.5% 1.1% 3

q24 Of WIC participants seeking recertification, what percentage is denied certification? (A--; B--)

1-<=10% 99.5% 95.8% 94.5% 94.5% 97.8% 972-11-20% .5% 3.7% 3.1% 5.5% 1.1% 13-21-30% -- .5% .5% -- -- 7-61-70% -- -- .5% -- -- 

q24a How confident are you in the range above? (A n.s.; B n.s.)

1-Very confident 89.2% 82.6% 77.2% 87.5% 83.2% 832-Somewhat confident 10.8% 14.8% 19.0% 11.0% 15.7% 123-Not very confident (i.e. a lot of guesswork involved) -- 2.6% 2.4% 1.5% -- 4

q28 Does the agency send an official letter of denial to applicants who are denied eligibility for WIC? (A n.s.; B n.s.)

1-Yes 71.6% 65.1% 74.1% 71.7% 68.4% 682-No 28.4% 34.9% 24.5% 28.3% 30.5% 3

TOTAL 671 1020 599 578 625 5Note: Percentages were calculated for all cases. NOTE A applies to the RELATIONSHIP crosstab (columns 1-3): ***p<.0001; **p<.01; *p<.05; n.s. non-significant ; -- N/A for the clients served crosstab. NOTE B applies to the SIZE crosstab (columns 4-7): ***p<.0001; **p<.01; *p<.05 n.s. non-significant; -- N/A for the clients served crosstab.
 D-23 National Surv

Table 14. WIC Agency Procedures: Percentage of Denied Certifications That Are Attributable to Various Eligibility Problems

The relationship of WIC local to State agency Clients served at the whole 

State affiliated Local government Non- government <750 750-1,999 2,00

q25_01_D Insufficient identification (A*; B n.s.) 59.2% 44.3% 51.3% 40.7% 55.3% 53q25_01 Insufficient identification (A*; B n.s.)

25.9 16.6 21.4 24.8 22.0 2

(26.6) (21.7) (24.6) (25.0) (24.8) (2

N=397 N=452 N=307 N=235 N=346 N

q25_02_D Income ineligibility (A n.s.; B n.s.) 94.8% 96.3% 98.6% 93.6% 96.7% 96q25_02 Income ineligibility (A n.s.; B n.s.)

65.5 66.0 67.2 60.4 72.3 6

(33.9) (35.1) (33.8) (35.5) (30.5) (3

N=636 N=983 N=591 N=541 N=604 N

q25_03_D Nutritional ineligibility (A n.s.; B n.s.) 28.8% 19.8% 17.1% 18.4% 20.1% 24q25_03 Nutritional ineligibility (A n.s.; B n.s.)

11.5 9.7 7.7 7.9 16.9 

(18.9) (16.3) (7.5) (5.1) (28.7) (

N=193 N=202 N=102 N=107 N=126 N

q25_04_D Residency ineligibility (A n.s.; B n.s.) 46.9% 39.1% 49.1% 41.9% 43.3% 49q25_04 Residency ineligibility (A n.s.; B n.s.)

14.5 15.5 11.3 13.9 17.1 1

(16.5) (16.2) (14.6) (13.7) (21.1) (1

N=315 N=399 N=294 N=242 N=271 N

q25_05_D Category ineligibility (A n.s.; B n.s.) 51.8% 56.6% 58.0% 54.3% 52.2% 55q25_05 Category ineligibility (A n.s.; B n.s.)

33.0 36.7 30.1 49.5 26.1 3

(37.2) (35.8) (31.4) (38.7) (30.5) (3

N=348 N=578 N=348 N=314 N=326 N

q25_95_D Other: Please Specify (A n.s.; B n.s.) 8.2% 6.3% 9.2% 4.5% 6.3% 9q25_95 Other: Please Specify (A*; B n.s.)

41.7 70.8 37.7 86.3 41.7 5

(33.6) (24.8) (41.1) (5.5) (38.6) (3

N=55 N=64 N=55 N=26 N=40 N

q25a How confident are you in the percentages entered above? (A n.s.; B n.s.)

1-Very confident 45.5% 43.2% 39.6% 50.5% 43.5% 42-Somewhat confident 36.6% 42.1% 47.7% 39.5% 38.1% 423-Not very confident (i.e. a lot of guesswork involved) 17.9% 14.8% 11.3% 10.0% 17.3% 15

TOTAL 671 1020 599 578 625 5Note 1: Percentages were calculated for all cases. Note 2: Averages were calculated for cases with valid data (>0). Note 3: Standard deviations for the averages are in parenthesis. NOTE A applies to the RELATIONSHIP crosstab (columns 1-3): ***p<.0001; **p<.01; *p<.05; n.s. non-significant ; -- N/A for the clients served crosstab. NOTE B applies to the SIZE crosstab (columns 4-7): ***p<.0001; **p<.01; *p<.05 n.s. non-significant; -- N/A for the clients served crosstab.
 D-24 National Surv

Table 15. WIC Agency Procedures: Information Kept on Denied Applicants

The relationship of WIC local to State agency Clients served at the whole age

State affiliated Local government Non- government <750 750-1,999 2,000-4,5

q26 Does the agency keep information on denied applicants? (A n.s.; B n.s.)

1-Yes 86.7% 84.8% 80.1% 79.4% 81.9% 82.1% 2-No 13.3% 15.2% 18.5% 20.6% 17.0% 17.9% 

q27a1 Name of applicant (A n.s.; B n.s.)

0-No 1.9% 1.8% 1.3% -- 3.3% 1.9% 1-Yes 98.1% 98.2% 98.7% 100.0% 96.7% 98.1% 

q27a2 Address (A*; B*)

0-No 9.1% 13.0% 18.5% 4.8% 10.5% 17.9% 1-Yes 90.9% 87.0% 81.5% 95.2% 89.5% 82.1% 

q27a3 Phone number (A*; B n.s.)

0-No 8.8% 17.0% 20.4% 7.4% 12.1% 20.8% 1-Yes 91.2% 83.0% 79.6% 92.6% 87.9% 79.2% 

q27a4 WIC applicant category (A n.s.; B n.s.)

0-No 13.3% 15.6% 19.5% 16.1% 13.6% 14.5% 1-Yes 86.7% 84.4% 80.5% 83.9% 86.4% 85.5% 

q27a5 Reason for denial (A n.s.; B n.s.)

0-No .8% 1.4% .6% 2.1% -- 1.1% 1-Yes 99.2% 98.6% 99.4% 97.9% 100.0% 98.9% 

q27a6 Date of application (A n.s.; B n.s.)

0-No 8.3% 9.9% 16.0% 15.5% 7.0% 10.3% 1-Yes 91.7% 90.1% 84.0% 84.5% 93.0% 89.7% 

q27a7 Date of denial (A n.s.; B n.s.)

0-No 1.2% 4.9% 2.6% 3.7% 4.9% 1.1% 1-Yes 98.8% 95.1% 97.4% 96.3% 95.1% 98.9% 

TOTAL 671 1020 599 578 625 528 Note: Percentages were calculated for cases that kept Information on denied applicants. NOTE A applies to the RELATIONSHIP crosstab (columns 1-3): ***p<.0001; **p<.01; *p<.05; n.s. non-significant ; -- N/A for the clients served crosstab. NOTE B applies to the SIZE crosstab (columns 4-7): ***p<.0001; **p<.01; *p<.05 n.s. non-significant; -- N/A for the clients served crosstab.
 D-25 National Surv

Table 16. WIC Agency Procedures: How Information is Kept on Denied Applicants

The relationship of WIC local to State agency Clients served at the whole 

State affiliated Local government Non- government <750 750-1,999 2,00

q27b_01 Name of Applicant (A*; B**)

1-Paper copy only 28.6% 33.8% 30.8% 32.2% 34.9% 262-Electronic copy only 14.5% 24.4% 11.7% 32.6% 11.9% 143-Both paper and electronic 56.9% 41.8% 57.5% 35.2% 53.2% 59

q27c_01_01 WIC State Agency (A n.s.; B n.s.)

0-No 67.1% 76.9% 68.1% 73.8% 67.6% 71-Yes 32.9% 23.1% 31.9% 26.2% 32.4% 28

q27c_01_02 Your Local Agency (A n.s.; B***)

0-No 24.8% 25.5% 32.7% 10.5% 16.8% 291-Yes 75.2% 74.5% 67.3% 89.5% 83.2% 70

q27c_01_03 Sites / Clinics (A**; B***)

0-No 49.6% 68.9% 53.8% 91.4% 62.7% 551-Yes 50.4% 31.1% 46.2% 8.6% 37.3% 45

q27b_02 Address (A*; B n.s.)

1-Paper copy only 26.7% 32.4% 29.0% 31.3% 36.2% 202-Electronic copy only 19.5% 32.9% 20.4% 31.8% 19.2% 283-Both paper and electronic 53.8% 34.8% 50.6% 36.9% 44.7% 5

q27c_02_01 WIC State Agency (A n.s.; B n.s.)

0-No 64.7% 75.0% 65.6% 72.5% 65.0% 681-Yes 35.3% 25.0% 34.4% 27.5% 35.0% 3

q27c_02_02 Your Local Agency (A n.s.; B***)

0-No 25.3% 25.6% 30.9% 11.0% 19.8% 281-Yes 74.7% 74.4% 69.1% 89.0% 80.2% 7

q27c_02_03 Sites / Clinics (A**; B***)

0-No 49.1% 69.1% 58.7% 91.0% 61.3% 551-Yes 50.9% 30.9% 41.3% 9.0% 38.7% 44

q27b_03 Phone Number (A*; B n.s.)

1-Paper copy only 26.6% 30.2% 28.9% 29.4% 34.9% 182-Electronic copy only 21.1% 35.7% 20.2% 32.7% 19.5% 333-Both paper and electronic 52.3% 34.2% 50.9% 38.0% 45.5% 47

q27c_03_01 WIC State Agency (A n.s.; B n.s.)

0-No 64.4% 73.8% 65.5% 71.7% 64.3% 671-Yes 35.6% 26.2% 34.5% 28.3% 35.7% 33

q27c_03_02 Your Local Agency (A n.s.; B***)

0-No 25.2% 26.6% 30.6% 11.3% 20.2% 281-Yes 74.8% 73.4% 69.4% 88.7% 79.8% 7

q27c_03_03 Sites / Clinics (A*; B***)

0-No 49.3% 68.1% 59.4% 90.7% 60.6% 541-Yes 50.7% 31.9% 40.6% 9.3% 39.4% 45

q27b_04 WIC Applicant Category (A n.s.; B n.s.)

1-Paper copy only 24.6% 27.9% 30.8% 27.3% 31.2% 222-Electronic copy only 21.5% 33.5% 20.4% 38.3% 21.7% 253-Both paper and electronic 53.9% 38.6% 48.7% 34.4% 47.2% 52

q27c_04_01 WIC State Agency (A n.s.; B n.s.)

0-No 63.2% 73.6% 63.9% 68.8% 63.7% 681-Yes 36.8% 26.4% 36.1% 31.2% 36.3% 3

q27c_04_02 Your Local Agency (A n.s.; B***)

0-No 25.7% 26.8% 35.5% 12.5% 20.5% 281-Yes 74.3% 73.2% 64.5% 87.5% 79.5% 7

q27c_04_03 Sites / Clinics (A***; B***)

0-No 46.0% 68.8% 54.2% 89.7% 61.5% 531-Yes 54.0% 31.2% 45.8% 10.3% 38.5% 46
 D-26 National Surv

The relationship of WIC local to State agency Clients served at the whole 

State affiliated Local government Non- government <750 750-1,999 2,00

q27b_05 Reason for Denial (A n.s.; B*)

1-Paper copy only 29.6% 37.0% 38.2% 39.1% 36.4% 292-Electronic copy only 17.5% 24.7% 12.7% 31.4% 16.5% 163-Both paper and electronic 52.9% 38.3% 49.0% 29.5% 47.1% 54

q27c_05_01 WIC State Agency (A n.s.; B n.s.)

0-No 65.6% 78.9% 69.3% 73.2% 69.1% 721-Yes 34.4% 21.1% 30.7% 26.8% 30.9% 27

q27c_05_02 Your Local Agency (A n.s.; B***)

0-No 24.9% 26.6% 32.4% 10.7% 16.3% 301-Yes 75.1% 73.4% 67.6% 89.3% 83.7% 69

q27c_05_03 Sites / Clinics (A**; B***)

0-No 48.2% 69.0% 55.3% 91.2% 64.2% 541-Yes 51.8% 31.0% 44.7% 8.8% 35.8% 45

q27b_06 Date of Application (A n.s.; B n.s.)

1-Paper copy only 27.1% 32.8% 32.9% 34.5% 34.7% 22-Electronic copy only 15.9% 26.3% 14.7% 29.1% 15.3% 193-Both paper and electronic 57.1% 40.9% 52.4% 36.4% 49.9% 58

q27c_06_01 WIC State Agency (A n.s.; B n.s.)

0-No 65.4% 75.3% 65.5% 69.0% 66.3% 701-Yes 34.6% 24.7% 34.5% 31.0% 33.7% 29

q27c_06_02 Your Local Agency (A n.s.; B***)

0-No 22.4% 27.5% 33.3% 9.6% 16.0% 291-Yes 77.6% 72.5% 66.7% 90.4% 84.0% 70

q27c_06_03 Sites / Clinics (A*; B***)

0-No 50.7% 68.0% 52.8% 92.6% 62.7% 541-Yes 49.3% 32.0% 47.2% 7.4% 37.3% 45

q27b_07 Date of Denial (A n.s.; B*)

1-Paper copy only 28.7% 36.4% 34.7% 40.0% 34.3% 252-Electronic copy only 15.1% 23.3% 13.2% 28.1% 14.5% 163-Both paper and electronic 56.1% 40.3% 52.1% 32.0% 51.3% 58

q27c_07_01 WIC State Agency (A n.s.; B n.s.)

0-No 65.5% 76.6% 71.6% 72.8% 68.9% 71-Yes 34.5% 23.4% 28.4% 27.2% 31.1% 28

q27c_07_02 Your Local Agency (A n.s.; B***)

0-No 25.0% 26.9% 31.9% 10.9% 16.0% 291-Yes 75.0% 73.1% 68.1% 89.1% 84.0% 70

q27c_07_03 Sites / Clinics (A**; B***)

0-No 48.0% 68.5% 54.3% 91.1% 62.3% 541-Yes 52.0% 31.5% 45.7% 8.9% 37.7% 45

TOTAL 671 1020 599 578 625 5Note: Percentages were calculated for cases that kept Information on denied applicants. NOTE A applies to the RELATIONSHIP crosstab (columns 1-3): ***p<.0001; **p<.01; *p<.05; n.s. non-significant ; -- N/A for the clients served crosstab. NOTE B applies to the SIZE crosstab (columns 4-7): ***p<.0001; **p<.01; *p<.05 n.s. non-significant; -- N/A for the clients served crosstab.
 D-27 National Surv

Table 17. WIC Agency Procedures: Screened and Denied Eligibility

The relationship of WIC local to State agency Clients served at the whole age

State affiliated Local government Non- government <750 750-1,999 2,000-4,5

q29 Can an applicant be screened and denied eligibility by telephone? (A*; B***)

1-Yes 38.2% 59.9% 55.3% 68.8% 46.8% 56.6% 2-No 61.8% 40.1% 43.3% 31.2% 52.1% 43.4% 

q30_1 Insufficient identification (A n.s.; B n.s.)

0-No 91.0% 91.7% 92.9% 91.2% 89.8% 93.5% 1-Yes 9.0% 8.3% 7.1% 8.8% 10.2% 6.5% 

q30_2 Income eligibility (A*; B n.s.)

0-No .8% 1.0% 6.5% 5.1% -- 1.5% 1-Yes 99.2% 99.0% 93.5% 94.9% 100.0% 98.5% 

q30_3 Nutritional eligibility (A --; B n.s.)

0-No 90.3% 98.1% 100.0% 96.2% 97.1% 100.0% 1-Yes 9.7% 1.9% -- 3.8% 2.9% -- 

q30_4 Residency eligibility (A n.s.; B n.s.)

0-No 55.1% 45.3% 45.7% 59.2% 37.2% 46.4% 1-Yes 44.9% 54.7% 54.3% 40.8% 62.8% 53.6% 

q30_5 Category eligibility (A n.s.; B***)

0-No 36.8% 35.4% 20.0% 48.2% 32.7% 18.1% 1-Yes 63.2% 64.6% 80.0% 51.8% 67.3% 81.9% 

q30_6 Other: PLEASE SPECIFY (A n.s.; B n.s.)

0-No 97.0% 97.4% 97.0% 100.0% 93.5% 96.8% 1-Yes 3.0% 2.6% 3.0% -- 6.5% 3.2% 

TOTAL 671 1020 599 578 625 528 Note: Percentages were calculated for cases that screened and denied eligibility by telephone. NOTE A applies to the RELATIONSHIP crosstab (columns 1-3): ***p<.0001; **p<.01; *p<.05; n.s. non-significant ; -- N/A for the clients served crosstab. NOTE B applies to the SIZE crosstab (columns 4-7): ***p<.0001; **p<.01; *p<.05 n.s. non-significant; -- N/A for the clients served crosstab.Table 18. WIC Agency Services: Nutrition Services Offered

The relationship of WIC local to State agency Clients served at the whole age

State affiliated Local government Non- government <750 750-1,999 2,000-4,5

q31_1 One-on-one counseling (A --; B n.s.) 100.0% 99.7% 98.4% 100.0% 98.9% 100.0% q31_2 Group educational sessions (A*; B***) 80.9% 67.8% 79.2% 57.0% 75.1% 81.2% q31_3 Internet-based nutrition education for clients to use

(A n.s.; B*) 26.7% 35.0% 30.9% 19.3% 40.0% 32.2% 

q31_4 Other: PLEASE SPECIFY (A n.s.; B*) 9.6% 12.5% 10.1% 5.9% 7.2% 12.8% TOTAL 671 1020 599 578 625 528 Note: Percentages were calculated for all cases. NOTE A applies to the RELATIONSHIP crosstab (columns 1-3): ***p<.0001; **p<.01; *p<.05; n.s. non-significant ; -- N/A for the clients served crosstab. NOTE B applies to the SIZE crosstab (columns 4-7): ***p<.0001; **p<.01; *p<.05 n.s. non-significant; -- N/A for the clients served crosstab.
 D-28 National Surv

Table 19. WIC Agency Services: Providers of Nutrition Services

The relationship of WIC local to State agency Clients served at the whole age

State affiliated Local government Non- government <750 750-1,999 2,000-4,5

q32_01 WIC Director or Clinic Supervisor

(A*; B n.s.) 37.9% 57.4% 58.9% 44.5% 45.8% 63.3% 

q32_02 Registered Dietitians (A n.s.; B*) 85.0% 78.7% 82.9% 68.8% 84.7% 84.2% q32_03 Degreed/Licensed Nutritionists

(A n.s.; B***) 68.2% 57.7% 64.1% 42.4% 57.5% 72.4% 

q32_04 Trained Nutrition Paraprofessional

(A n.s.; B***) 47.8% 42.5% 53.1% 26.1% 43.9% 54.3% 

q32_05 Registered Nurses/Physicians Assistants

(A***; B***) 67.6% 49.4% 33.8% 70.7% 66.3% 35.6% 

q32_06 Physicians (A --; B --) -- .7% -- -- 1.1% -- q32_07 Social Workers/ Psychologists/ Therapists

(A*; B --) 4.8% .6% 1.8% 3.5% 3.0% 2.0% 

q32_08 Other Health Professionals not listed here

(A n.s.; B n.s.) 10.2% 9.1% 12.5% 8.3% 8.0% 9.6% 

q32_09 Other Non-Health Professionals not listed here

(A n.s.; B n.s.) 4.8% 7.3% 9.0% 11.9% 4.0% 7.6% 

q32_10 Administrative/clerical/support staff

(A n.s.; B n.s.) 13.0% 11.8% 18.8% 14.7% 7.9% 18.2% 

q32_11 Peer Counselors (A n.s.; B**) 32.8% 30.2% 35.9% 23.0% 26.9% 37.7% TOTAL 671 1020 599 578 625 528 Note: Percentages were calculated for all cases. NOTE A applies to the RELATIONSHIP crosstab (columns 1-3): ***p<.0001; **p<.01; *p<.05; n.s. non-significant ; -- N/A for the clients served crosstab. NOTE B applies to the SIZE crosstab (columns 4-7): ***p<.0001; **p<.01; *p<.05 n.s. non-significant; -- N/A for the clients served crosstab.
 D-29 National Surv

Table 20. WIC Agency Services: Providers of Nutrition Services

The relationship of WIC local to State agency Clients served at the whole age

State affiliated Local government Non- government <750 750-1,999 2,000-4,5

q32_01 WIC Director or Clinic Supervisor

(A*; B n.s.) 37.9% 57.4% 58.9% 44.5% 45.8% 63.3% 

q32_02 Registered Dietitians (A n.s.; B n.s.) 85.0% 78.7% 82.9% 68.8% 84.7% 84.2% q32_03 Degreed/Licensed Nutritionists

(A n.s.; B n.s.) 68.2% 57.7% 64.1% 42.4% 57.5% 72.4% 

q32_04 Trained Nutrition Paraprofessional

(A n.s.; B n.s.) 47.8% 42.5% 53.1% 26.1% 43.9% 54.3% 

q32_05 Registered Nurses/Physicians Assistants

(A***; B n.s.) 67.6% 49.4% 33.8% 70.7% 66.3% 35.6% 

q32_06 Physicians (A --; B --) -- .7% -- -- 1.1% -- q32_07 Social Workers/ Psychologists/ Therapists

(A*; B n.s.) 4.8% .6% 1.8% 3.5% 3.0% 2.0% 

q32_08 Other Health Professionals not listed here

(A n.s.; B n.s.) 10.2% 9.1% 12.5% 8.3% 8.0% 9.6% 

q32_09 Other Non-Health Professionals not listed here

(A n.s.; B n.s.) 4.8% 7.3% 9.0% 11.9% 4.0% 7.6% 

q32_10 Administrative/clerical/support staff

(A n.s.; B n.s.) 13.0% 11.8% 18.8% 14.7% 7.9% 18.2% 

q32_11 Peer Counselors (A n.s.; B n.s.) 32.8% 30.2% 35.9% 23.0% 26.9% 37.7% TOTAL 671 1020 599 578 625 528 Note: Percentages were calculated for all cases. NOTE A applies to the RELATIONSHIP crosstab (columns 1-3): ***p<.0001; **p<.01; *p<.05; n.s. non-significant ; -- N/A for the clients served crosstab. NOTE B applies to the SIZE crosstab (columns 4-7): ***p<.0001; **p<.01; *p<.05 n.s. non-significant; -- N/A for the clients served crosstab.
 D-30 National Surv

Table 21. WIC Agency Services: Nutrition Services

The relationship of WIC local to State agency Clients served at the whole 

State affiliated Local government Non- government <750 750-1,999 2,00

q33 On average, how much time is spent giving nutrition education to an adult client during the certification process? (A*; B n.s.)

1-<5 minutes -- 1.5% .6% -- 1.1% 2-5 – 9 minutes 27.2% 26.6% 16.5% 24.6% 18.9% 243-10 – 19 minutes 60.8% 51.4% 58.6% 53.6% 62.4% 534-20 – 29 minutes 9.2% 16.3% 15.5% 16.8% 13.2% 165-30 – 44 minutes 2.8% 3.7% 6.2% 5.0% 3.3% 36-45 – 59 minutes -- .4% .6% -- -- 7-60 minutes or more -- -- .5% -- -- 

q34 In a given 3-month period, on average, how much time is spent giving nutrition education to an adult client during follow-up visits (excluding the initial certification)? (A n.s.; B n.s.)

1-<5 minutes 4.9% 6.6% 1.8% 3.9% 5.5% 52-5 – 9 minutes 27.7% 30.6% 29.0% 36.5% 29.9% 283-10 – 19 minutes 43.8% 39.6% 35.6% 34.5% 42.4% 44-20 – 29 minutes 14.3% 11.0% 20.3% 10.0% 12.9% 155-30 – 44 minutes 7.5% 10.7% 9.0% 15.1% 6.2% 66-45 – 59 minutes .8% 1.0% 2.2% -- 1.9% 7-60 minutes or more 1.0% .6% .7% -- -- 2

q35 What percentage of infants are certified off-site (e.g. in the hospital)? (A n.s.; B*)

2.0 2.9 3.3 .9 4.1 

(7.1) (14.1) (13.1) (2.8) (16.6) (

N=671 N=1020 N=591 N=578 N=618 N

TOTAL 671 1020 599 578 625 5Note 1: Percentages were calculated for all cases. Note 2: Averages were calculated for all cases. Note 3: Standard deviations for the averages are in parenthesis. NOTE A applies to the RELATIONSHIP crosstab (columns 1-3): ***p<.0001; **p<.01; *p<.05; n.s. non-significant ; -- N/A for the clients served crosstab. NOTE B applies to the SIZE crosstab (columns 4-7): ***p<.0001; **p<.01; *p<.05 n.s. non-significant; -- N/A for the clients served crosstab.
 D-31 National Surv

Table 22. WIC Agency Services: Outreach Activities to Help Bring Qualified Infants into the WIC Program

The relationship of WIC local to State agency Clients served at the whole age

State affiliated Local government Non- government <750 750-1,999 2,000-4,5

q36_1 Agency staff visit currentlycertified and prospective WIC mothers in the hospital

(A n.s.; B n.s.) 16.3% 14.8% 23.8% 14.8% 14.6% 15.3% 

q36_2 Agency provides general information and/or specific forms to the hospital for distribution

(A*; B n.s.) 69.3% 66.4% 79.3% 64.0% 69.5% 71.5% 

q36_3 Agency staff provide pregnant mothers with WIC forms (for their infants) for hospital physicians to fill out

(A*; B*) 38.9% 31.6% 45.3% 29.0% 31.4% 42.4% 

q36_4 Agency joins with other social service agencies to provide a place at the hospital where prospective clients can shop services, all in one place

(A n.s.; B**) 6.8% 5.3% 12.6% 2.6% 3.3% 8.2% 

q36_5 Other: PLEASE SPECIFY: (A**; B n.s.) 7.8% 20.5% 14.3% 17.6% 12.1% 16.6% TOTAL 671 1020 599 578 625 528 Note: Percentages were calculated for all cases. NOTE A applies to the RELATIONSHIP crosstab (columns 1-3): ***p<.0001; **p<.01; *p<.05; n.s. non-significant ; -- N/A for the clients served crosstab. NOTE B applies to the SIZE crosstab (columns 4-7): ***p<.0001; **p<.01; *p<.05 n.s. non-significant; -- N/A for the clients served crosstab.

Table 23. WIC Agency Organization

The relationship of WIC local to State agency Clients se

(ad

State 

affiliated

Local 

government

Nongovernment <750 750- 1,999 

q37 How would you describe the relationship of your WIC local agency to the WIC State agency? 

(A --; B**)

1-Part of State agency 100.0% -- -- 30.2% 38.9% 2-A local government entity administering the WIC program -- 94.0% -- 51.4% 38.4% 3-A non-profit organization that has been contracted to run th -- -- 100.0% 15.9% 18.6% 4-Not a local agency, but rather a clinic under a local agency -- 6.0% -- 2.6% 4.0% 

TOTAL 671 1020 599 578 625 Note: Percentages were calculated for all cases. 

NOTE A applies to the RELATIONSHIP crosstab (columns 1-3): ***p<.0001; **p<.01; *p<.05; n.s. non-significant ; -- N/A for the clients served crosstab. NOTE B applies to the SIZE crosstab (columns 4-7): ***p<.0001; **p<.01; *p<.05 n.s. non-significant; -- N/A for the clients served crosstab.
 D-32 National Surv

Table 24. WIC Agency Organization: Other WIC Sites That Operate under the Authority of the Local Agency

The relationship of WIC local to State agency Clients served at the whole ag

State affiliated Local government Non- government <750 750-1,999 2,000-4

q38a_D Clinics (A*; B**) 79.9% 83.3% 90.6% 76.5% 78.2% 85.1% q38a Clinics (A**; B***)

4.5 2.6 3.5 2.0 2.4 2.7 

(4.9) (3.3) (5.2) (3.1) (3.2) (2.8

N=536 N=849 N=543 N=442 N=489 N=44

q38B_D Satellites (A***; B**) 19.1% 31.4% 45.9% 20.5% 28.0% 41.4% q38b Satellites (A**; B*)

3.1 2.9 4.7 4.1 3.2 2.8 

(3.9) (2.0) (5.0) (3.7) (3.4) (2.6

N=128 N=320 N=275 N=118 N=175 N=21

q38C_D Mobile Units (A***; B n.s.) 1.4% 1.2% 6.4% -- -- 4.2% q38c Mobile Units (A n.s.; B n.s.)

1.0 2.0 1.1 -- -- 1.0 

(.0) (1.7) (.3) -- -- (.0) 

N=10 N=13 N=38 N=0 N=0 N=2

TOTAL 671 1020 599 578 625 528 Note 1: Percentages were calculated for all cases. Note 2: Averages were calculated for cases with valid data (>0). Note 3: Standard deviations for the averages are in parenthesis. NOTE A applies to the RELATIONSHIP crosstab (columns 1-3): ***p<.0001; **p<.01; *p<.05; n.s. non-significant ; -- N/A for the clients served crosstab. NOTE B applies to the SIZE crosstab (columns 4-7): ***p<.0001; **p<.01; *p<.05 n.s. non-significant; -- N/A for the clients served crosstab.
 D-33 National Surv

Table 25. WIC Agency Organization: Certification Services

The relationship of WIC local to State agency Clients served at the whole age

State affiliated Local government Non- government <750 750-1,999 2,000-4,5

q39a_1 Conducts certifications (A n.s.; B n.s.) 97.6% 98.6% 95.2% 98.1% 94.7% 98.4% q39a_2 Performs blood testing (A n.s.; B n.s.) 89.3% 85.4% 83.6% 87.6% 88.6% 86.3% q39a_3 Takes anthropometric measurements for height, weight, and body mass index (BMI)

(A n.s.; B n.s.) 95.3% 94.1% 94.5% 90.2% 93.4% 97.1% 

q39a_4 Conducts nutrition counseling (A n.s.; B n.s.) 96.6% 95.4% 95.2% 91.7% 95.8% 96.3% q39a_5 Offers other educational seminars (e.g. on breastfeeding)

(A*; B n.s.) 82.5% 75.2% 89.0% 75.9% 80.2% 81.6% 

q39a_6 Distributes food instruments (A n.s.; B n.s.) 91.1% 94.1% 90.8% 86.6% 91.7% 94.6% q39a_7 Provides referrals to other services

(A n.s.; B*) 97.8% 94.2% 94.4% 89.1% 96.9% 96.3% 

q39a_8 Has access to WIC participant records electronically

(A n.s.; B n.s.) 89.6% 94.4% 92.2% 90.2% 87.9% 96.4% 

q39a_9 Stores paper copies of the WIC participant records

(A n.s.; B n.s.) 81.8% 72.2% 68.8% 69.5% 73.2% 73.9% 

TOTAL 671 1020 599 578 625 528 Note: Percentages were calculated for all cases. NOTE A applies to the RELATIONSHIP crosstab (columns 1-3): ***p<.0001; **p<.01; *p<.05; n.s. non-significant ; -- N/A for the clients served crosstab. NOTE B applies to the SIZE crosstab (columns 4-7): ***p<.0001; **p<.01; *p<.05 n.s. non-significant; -- N/A for the clients served crosstab.
 D-34 National Surv

Table 26. WIC Agency Organization: the Extent of Certification Services Provided by Clinics

The relationship of WIC local to State agency Clients served at the whole a

State affiliated Local government Non- government <750 750-1,999 2,000-4

q39b_1 Conducts certifications : (Clinics) (A n.s.; B n.s.)

1-All can do 87.0% 92.7% 90.1% 83.9% 88.6% 94.42-Some can do 5.1% 4.0% 4.7% 2.9% 5.3% 5.6% 3-None can do 7.9% 3.3% 5.3% 13.1% 6.1% -- 

q39b_2 Performs blood testing : (Clinics) (A n.s.; B n.s.)

1-All can do 87.3% 93.7% 90.5% 92.2% 92.5% 89.22-Some can do 7.3% 5.4% 7.0% 3.1% 3.8% 9.6% 3-None can do 5.4% .9% 2.5% 4.7% 3.7% 1.2% 

q39b_3 Takes anthropometric measurements for height, weight and body mass index (BMI): (Clinics) (A n.s.; B n.s.)

1-All can do 88.5% 93.5% 93.3% 89.0% 91.2% 93.42-Some can do 5.1% 4.3% 4.9% 3.0% 3.9% 6.6% 3-None can do 6.4% 2.2% 1.8% 8.0% 4.9% -- 

q39b_4 Conducts nutrition counseling: (Clinics) (A n.s.; B n.s.)

1-All can do 87.0% 90.0% 88.6% 80.6% 88.6% 91.32-Some can do 6.7% 6.6% 5.2% 8.2% 4.2% 8.7% 3-None can do 6.3% 3.3% 6.2% 11.2% 7.2% -- 

q39b_5 Offers other educational seminars (e.g. on breastfeeding): (Clinics) (A n.s.; B n.s.)

1-All can do 82.3% 88.2% 84.6% 80.9% 89.5% 82.42-Some can do 11.9% 11.3% 10.5% 9.9% 6.4% 17.63-None can do 5.8% .5% 4.9% 9.3% 4.0% -- 

q39b_6 Distributes food instruments: (Clinics) (A n.s.; B n.s.)

1-All can do 85.4% 93.7% 94.6% 86.8% 89.9% 96.02-Some can do 6.4% 2.5% 1.6% 3.0% 2.5% 3.2% 3-None can do 8.2% 3.8% 3.7% 10.2% 7.6% .8% 

q39b_7 Provides referrals to other services: (Clinics) (A n.s.; B n.s.)

1-All can do 90.1% 97.3% 95.5% 89.0% 93.1% 99.32-Some can do 3.7% 2.3% 1.8% 3.0% 4.1% .7% 3-None can do 6.3% .4% 2.7% 8.0% 2.9% -- 

q39b_8 Has access to WIC participant records electronically: (Clinics) (A n.s.; B n.s.)

1-All can do 87.3% 93.2% 91.1% 83.6% 84.8% 99.32-Some can do 2.6% 3.0% 1.6% 3.0% 4.5% -- 3-None can do 10.1% 3.8% 7.2% 13.4% 10.7% .7% 

q39b_9 Stores paper copies of the WIC participant records: (Clinics) (A n.s.; B n.s.)

1-All can do 89.1% 87.9% 94.2% 86.1% 87.2% 95.62-Some can do 3.8% 8.3% 2.6% 3.7% 6.0% 3.2% 3-None can do 7.1% 3.8% 3.2% 10.1% 6.8% 1.2% 

TOTAL 671 1020 599 578 625 528 Note: Percentages were calculated for cases that provide certification services. NOTE A applies to the RELATIONSHIP crosstab (columns 1-3): ***p<.0001; **p<.01; *p<.05; n.s. non-significant ; -- N/A for the clients served crosstab. NOTE B applies to the SIZE crosstab (columns 4-7): ***p<.0001; **p<.01; *p<.05 n.s. non-significant; -- N/A for the clients served crosstab.
 D-35 National Surv

Table 27. WIC Agency Organization: the Extent of Certification Services Provided by Satellites

The relationship of WIC local to State agency Clients served at the whole a

State affiliated Local government Non- government <750 750-1,999 2,000-4

q39c_1 Conducts certifications: (Satellites) (A --; B --)

1-All can do 100.0% 91.8% 85.1% 66.0% 100.0% 96.62-Some can do -- 7.6% 7.0% 21.7% -- 3.4% 3-None can do -- .6% 7.8% 12.4% -- -- 

q39c_2 Performs blood testing: (Satellites) (A*; B**)

1-All can do 73.0% 93.2% 81.0% 55.9% 89.1% 95.92-Some can do 22.3% 1.2% 8.6% 29.9% 3.8% 2.1% 3-None can do 4.7% 5.6% 10.4% 14.2% 7.1% 2.1% 

q39c_3 Takes anthropometric measurements for height, weight and body mass index (BMI): (Satellites) (A --; B --)

1-All can do 74.7% 92.4% 84.2% 48.8% 92.8% 96.12-Some can do 25.3% 5.9% 9.2% 38.8% 7.2% 3.9% 3-None can do -- 1.7% 6.7% 12.4% -- -- 

q39c_4 Conducts nutrition counseling: (Satellites) (A --; B --)

1-All can do 100.0% 92.0% 88.5% 75.1% 96.1% 98.42-Some can do -- 5.3% 5.0% 12.5% -- 1.6% 3-None can do -- 2.7% 6.6% 12.4% 3.9% -- 

q39c_5 Offers other educational seminars (e.g. on breastfeeding): (Satellites) (A n.s.; B n.s.)

1-All can do 58.8% 76.2% 69.7% 64.2% 75.8% 72.92-Some can do 33.2% 16.3% 17.9% 18.0% 17.9% 18.53-None can do 7.9% 7.5% 12.4% 17.8% 6.3% 8.5% 

q39c_6 Distributes food instruments: (Satellites) (A --; B --)

1-All can do 100.0% 96.0% 95.3% 100.0% 95.9% 100.02-Some can do -- 1.3% 3.4% -- -- -- 3-None can do -- 2.7% 1.3% -- 4.1% -- 

q39c_7 Provides referrals to other services: (Satellites) (A --; B --)

1-All can do 100.0% 96.5% 92.5% 85.8% 96.1% 100.02-Some can do -- .7% .9% -- -- -- 3-None can do -- 2.8% 6.7% 14.2% 3.9% -- 

q39c_8 Has access to WIC participant records electronically: (Satellites) (A*; B --)

1-All can do 65.5% 92.6% 85.5% 61.6% 80.4% 95.42-Some can do 5.3% 2.5% 6.8% 8.9% -- 4.6% 3-None can do 29.2% 4.9% 7.6% 29.5% 19.6% -- 

q39c_9 Stores paper copies of the WIC participant records: (Satellites) (A n.s.; B n.s.)

1-All can do 36.6% 48.5% 61.9% -- 46.8% 67.32-Some can do 21.4% 20.0% 18.3% 31.9% 12.4% 15.23-None can do 42.0% 31.5% 19.9% 68.1% 40.7% 17.5

TOTAL 671 1020 599 578 625 528 Note: Percentages were calculated for cases that provide certification services. NOTE A applies to the RELATIONSHIP crosstab (columns 1-3): ***p<.0001; **p<.01; *p<.05; n.s. non-significant ; -- N/A for the clients served crosstab. NOTE B applies to the SIZE crosstab (columns 4-7): ***p<.0001; **p<.01; *p<.05 n.s. non-significant; -- N/A for the clients served crosstab.
 D-36 National Surv

Table 28. WIC Agency Organization: the Extent of Certification Services Provided by Mobile Units

The relationship of WIC local to State agency Clients served at the whole a

State affiliated Local government Non- government <750 750-1,999 2,000-4

q39d_1 Conducts certifications: (Mobile Units)

1-All can do 100.0% 75.9% 84.2% -- -- 78.42-Some can do -- -- 3.4% -- -- -- 3-None can do -- 24.1% 12.4% -- -- 21.6

q39d_2 Performs blood testing: (Mobile Units)

1-All can do 100.0% 86.5% 79.5% -- -- 78.42-Some can do -- 13.5% 3.5% -- -- -- 3-None can do -- -- 16.9% -- -- 21.6

q39d_3 Takes anthropometric measurements for height, weight and body mass index (BMI): (Mobile Units)

1-All can do 100.0% 75.9% 84.2% -- -- 78.42-Some can do -- -- 3.4% -- -- -- 3-None can do -- 24.1% 12.4% -- -- 21.6

q39d_4 Conducts nutrition counseling: (Mobile Units)

1-All can do 100.0% 75.9% 87.7% -- -- 100.02-Some can do -- -- 12.3% -- -- -- 3-None can do -- 24.1% -- -- -- -- 

q39d_5 Offers other educational seminars (e.g. on breastfeeding): (Mobile Units)

1-All can do 100.0% 56.1% 50.0% -- -- 59.32-Some can do -- -- 16.2% -- -- -- 3-None can do -- 43.9% 33.8% -- -- 40.7

q39d_6 Distributes food instruments: (Mobile Units)

1-All can do 100.0% 53.5% 87.7% -- -- 100.02-Some can do -- -- 12.3% -- -- -- 3-None can do -- 46.5% -- -- -- -- 

q39d_7 Provides referrals to other services: (Mobile Units)

1-All can do 100.0% 75.9% 96.2% -- -- 100.02-Some can do -- -- 3.8% -- -- -- 3-None can do -- 24.1% -- -- -- -- 

q39d_8 Has access to WIC participant records electronically: (Mobile Units)

1-All can do 100.0% 53.5% 84.2% -- -- 78.42-Some can do -- -- 3.4% -- -- -- 3-None can do -- 46.5% 12.4% -- -- 21.6

q39d_9 Stores paper copies of the WIC participant records: (Mobile Units)

1-All can do 100.0% 30.0% 75.4% -- -- 73.52-Some can do -- -- 3.8% -- -- -- 3-None can do -- 70.0% 20.7% -- -- 26.5

TOTAL 671 1020 599 578 625 528 Note: Percentages were calculated for cases that provide certification services. 

N/A for the crosstabs. 
 D-37 National Surv

Table 29. WIC Agency Organization: Distribution and Average Allocation of Nutrition Services and Administration (NSA) Funds

The relationship of WIC local to State agency Clients served at the whole 

State affiliated Local government Non- government <750 750-1,999 2,00

q40_a_n Certification and recertification (A n.s.; B n.s.) 76.6% 77.3% 74.2% 78.5% 77.2% 66q40_a_number Certification and re-certification: Percent (A n.s.; B n.s.)

43.4 42.1 40.5 38.3 42.3 4

(17.7) (16.9) (15.4) (17.4) (16.3) (1

N=514 N=788 N=445 N=454 N=482 N

q40_B_n Nutrition education (A n.s.; B n.s.) 76.6% 77.3% 74.2% 78.5% 77.2% 66q40_b_number Nutrition education: Percent (A**; B n.s.)

25.5 26.3 31.5 27.8 27.9 2

(9.5) (8.5) (11.5) (9.6) (10.0) (

N=514 N=788 N=445 N=454 N=482 N

q40_C_n Breastfeeding promotion and support (A n.s.; B n.s.) 78.6% 76.6% 73.7% 78.5% 79.5% 66q40_c_number Breastfeeding promotion and support: Percent (A n.s.; B n.s.)

13.3 15.9 13.9 17.5 15.3 1

(15.8) (14.8) (7.4) (14.7) (18.9) (

N=528 N=782 N=442 N=454 N=497 N

q40_D_n Administration (A n.s.; B n.s.) 77.6% 78.9% 74.2% 81.4% 78.3% 66q40_d_number Administration: Percent (A*; B n.s.)

21.1 18.3 14.2 19.4 19.3 1

(18.1) (16.8) (11.1) (20.8) (15.3) (1

N=521 N=805 N=445 N=471 N=489 N

TOTAL 671 1020 599 578 625 5Note 1: Percentages were calculated for all cases. Note 2: Averages were calculated for cases with valid data (>0) Note 3: Standard deviations for the averages are in parenthesis. NOTE A applies to the RELATIONSHIP crosstab (columns 1-3): ***p<.0001; **p<.01; *p<.05; n.s. non-significant ; -- N/A for the clients served crosstab. NOTE B applies to the SIZE crosstab (columns 4-7): ***p<.0001; **p<.01; *p<.05 n.s. non-significant; -- N/A for the clients served crosstab.
 D-38 National Surv

Table 30. WIC Agency Staff

The relationship of WIC local to State agency Clients served at the whole age

State affiliated Local government Non- government <750 750-1,999 2,000-4,5

q41_a_f WIC Director or Clinic Supervisor: full-time staff (working 32- 40+ hours/wk) 

(A n.s.; B***) 60.5% 69.5% 75.2% 43.3% 59.3% 80.1% 

q41_a_p WIC Director or Clinic Supervisor: part-time staff (working under 32 hours/wk) 

(A**; B**) 8.4% 25.9% 13.5% 28.0% 20.8% 12.2% 

q41_B_f Office Manager: full-time staff (working 32- 40+ hours/wk) 

(A n.s.; B***) 30.7% 21.6% 28.3% 15.5% 20.6% 21.9% 

q41_B_P Office Manager: part-time staff (working under 32 hours/wk) 

(A n.s.; B n.s.) 3.9% 6.3% 11.5% 11.5% 7.8% 4.2% 

q41_C_f Administrative Support Staff: full-time staff (working 32- 40+ hours/wk) 

(A n.s.; B***) 73.6% 60.8% 53.0% 40.7% 56.9% 69.1% 

q41_C_P Administrative Support Staff: part-time staff (working under 32 hours/wk) 

(A n.s.; B n.s.) 27.0% 32.4% 24.1% 30.9% 31.8% 24.5% 

q41_D_f Certification Specialist: fulltime staff (working 32- 40+ hours/wk) (A n.s.; B n.s.) 20.7% 14.7% 25.2% 14.7% 17.6% 20.7% q41_D_P Certification Specialist: parttime staff (working under 32 hours/wk) 

(A n.s.; B*) 6.8% 11.0% 6.7% 15.7% 4.7% 7.2% 

q41_E_f Registered Dietitian: full-time staff (working 32- 40+ hours/wk) 

(A n.s.; B***) 48.5% 42.8% 52.2% 14.1% 34.3% 60.8% 

q41_E_P Registered Dietitian: parttime staff (working under 32 hours/wk) 

(A n.s.; B n.s.) 28.7% 36.0% 40.1% 40.4% 35.3% 27.9% 

q41_F_f Degreed/Licensed Nutritionist: full-time staff (working 32- 40+ hours/wk) 

(A n.s.; B n.s.) 43.4% 35.7% 52.0% 10.1% 33.7% 52.8% 

q41_F_P Degreed/Licensed Nutritionist: part-time staff (working under 32 hours/wk) 

(A n.s.; B n.s.) 18.1% 19.1% 24.6% 28.3% 13.0% 20.9% 

q41_G_f Trained Nutrition Paraprofessional: full-time staff (working 32- 40+ hours/wk) 

(A n.s.; B n.s.) 26.6% 26.9% 33.9% 6.7% 20.9% 38.6% 

q41_G_P Trained Nutrition Paraprofessional: part-time staff (working under 32 hours/wk) 

(A n.s.; B n.s.) 16.2% 14.1% 16.8% 14.1% 18.6% 16.2% 

q41_H_f Registered Nurse/Physicians Assistant: full-time staff (working 32- 40+ hours/wk) 

(A***; B*) 47.4% 28.3% 19.5% 40.4% 38.9% 22.8% 

q41_H_P Registered Nurse/Physicians Assistant: part-time staff (working under 32 hours/wk) 

(A n.s.; B***) 22.7% 25.0% 23.0% 39.9% 28.1% 16.9% 

q41_I_f Physician: full-time staff (working 32- 40+ hours/wk) 

(A***; B n.s.) 4.8% .1% .5% 3.5% 1.9% -- 
 D-39 National Surv

The relationship of WIC local to State agency Clients served at the whole age

State affiliated Local government Non- government <750 750-1,999 2,000-4,5

q41_I_P Physician: part-time staff (working under 32 hours/wk) 

(A --; B --) 1.7% .2% -- -- -- .9% 

q41_J_f Social Worker/ Psychologist/ Therapist: full-time staff (working 32- 40+ hours/wk) 

(A --; B n.s.) 6.4% -- 1.0% 5.3% 1.9% .7% 

q41_J_P Social Worker/ Psychologist/ Therapist: part-time staff (working under 32 hours/wk)

(A --; B n.s.) 2.9% .4% -- -- 1.9% 1.7% 

q41_K_f Other Professional (nonmedical): full-time staff (working 32- 40+ hours/wk) 

(A n.s.; B**) 8.9% 10.9% 12.5% 3.8% 7.2% 13.4% 

q41_K_P Other Professional (nonmedical): part-time staff (working under 32 hours/wk) 

(A n.s.; B n.s.) 9.8% 4.3% 8.8% 6.1% 3.7% 9.2% 

q41_L_f Other: full-time staff (working 32- 40+ hours/wk) 

(A n.s.; B***) 16.8% 14.3% 19.1% 7.4% 7.3% 18.5% 

q41_L_P Other: part-time staff (working under 32 hours/wk) 

(A n.s.; B n.s.) 17.3% 11.4% 11.4% 11.9% 15.1% 11.2% 

q41_m_f Peer Counselor: full-time staff (working 32- 40+ hours/wk) 

(A n.s.; B n.s.) 1.8% 3.9% 2.7% -- 2.0% 2.3% 

q41_m_P Peer Counselor: part-time staff (working under 32 hours/wk) 

(A*; B n.s.) 3.8% 10.8% 11.3% 5.3% 9.2% 10.4% 

TOTAL 671 1020 599 578 625 528 Note: Percentages were calculated for all cases. NOTE A applies to the RELATIONSHIP crosstab (columns 1-3): ***p<.0001; **p<.01; *p<.05; n.s. non-significant ; -- N/A for the clients served crosstab. NOTE B applies to the SIZE crosstab (columns 4-7): ***p<.0001; **p<.01; *p<.05 n.s. non-significant; -- N/A for the clients served crosstab.
 D-40 National Surv

Table 30. WIC Agency Staff: Average Number

The relationship of WIC local to State agency Clients served at the whole agency 

State affiliated Local government Non- government <750 750-1,999 2,000-4,500 

q41_a_fulltime WIC Director or Clinic Supervisor : Number of full-time staff (working 32- 40+ hours/wk) (A n.s.; B***)

1.2 2.0 1.7 1.0 1.7 1.1 

(1.0) (5.0) (4.3) (.0) (5.2) (.5) 

N=406 N=709 N=451 N=250 N=371 N=423 

q41_a_parttime WIC Director or Clinic Supervisor : Number of parttime staff (working under 32 hours/wk) (A n.s.; B n.s.)

1.0 1.0 1.0 1.0 1.0 1.0 

(.0) (.2) (.1) (.0) (.0) (.0) 

N=56 N=265 N=81 N=162 N=130 N=65 

q41_b_fulltime Office Manager : Number of full-time staff (working 32- 40+ hours/wk) (A**; B n.s.)

 2.8 4.1 1.7 2.7 4.1 2.5 

(2.5) (9.5) (1.9) (2.5) (8.7) (6.8) 

N=206 N=221 N=170 N=90 N=129 N=116 

q41_b_parttime Office Manager : Number of part-time staff (working under 32 hours/wk) (A n.s.; B n.s.)

1.0 1.0 1.3 1.3 1.0 1.0 

(.0) (.2) (.5) (.4) (.0) (.0) 

N=26 N=64 N=69 N=66 N=49 N=22 

q41_c_fulltime Administrative Support Staff : Number of full-time staff (working 32- 40+ hours/wk) (A*; B*)

7.6 4.7 4.8 4.0 4.9 3.8 

(10.9) (8.9) (6.8) (6.5) (9.1) (5.0) 

N=494 N=620 N=318 N=235 N=356 N=365 

q41_c_parttime Administrative Support Staff : Number of part-time staff (working under 32 hours/wk) (A*; B n.s.)

3.1 2.1 1.7 1.9 2.7 2.3 

(2.1) (2.1) (1.5) (1.6) (1.8) (1.9) 

N=181 N=331 N=144 N=179 N=199 N=129 

q41_d_fulltime Certification Specialist : Number of full-time staff (working 32- 40+ hours/wk) (A n.s.; B n.s.)

6.9 6.5 8.6 10.9 3.0 4.9 

(6.3) (12.3) (12.0) (12.3) (2.6) (7.1) 

N=139 N=150 N=151 N=85 N=110 N=109 

q41_d_parttime Certification Specialist : Number of part-time staff (working under 32 hours/wk) (A n.s.; B n.s.)

1.8 1.6 2.5 1.4 2.0 1.5 

(.8) (2.4) (2.7) (.5) (1.4) (.7) 

N=46 N=112 N=40 N=91 N=29 N=38 

q41_e_fulltime Registered Dietitian : Number of full-time staff (working 32- 40+ hours/wk) (A n.s.; B***)

2.8 3.1 3.8 2.8 1.7 1.8 

(2.4) (4.0) (8.7) (1.5) (1.2) (1.4) 

N=326 N=437 N=313 N=81 N=214 N=321 

q41_e_parttime Registered Dietitian : Number of part-time staff (working under 32 hours/wk) (A n.s.; B n.s.)

1.7 1.6 2.1 1.6 1.3 2.5 

(1.2) (2.7) (1.9) (1.6) (.7) (4.1) 

N=193 N=367 N=240 N=233 N=221 N=147 

q41_f_fulltime Degreed/Licensed Nutritionist : Number of full-time staff (working 32- 40+ hours/wk) (A n.s.; B***)

3.8 4.0 4.7 2.0 2.1 2.5 

(4.8) (6.1) (6.3) (1.6) (2.8) (1.6) 

N=291 N=364 N=311 N=59 N=211 N=279 

q41_f_parttime Degreed/Licensed Nutritionist : Number of part-time staff (working under 32 hours/wk) (A n.s.; B**)

1.2 1.1 1.7 1.0 1.3 1.4 

(.8) (.5) (1.2) (.0) (.7) (.7) 

N=122 N=194 N=147 N=164 N=81 N=110 
 D-41 National Surv

The relationship of WIC local to State agency Clients served at the whole agency 

State affiliated Local government Non- government <750 750-1,999 2,000-4,500 

q41_g_fulltime Trained Nutrition Paraprofessional : Number of fulltime staff (working 32- 40+ hours/wk) (A***; B***)

5.1 8.4 12.4 1.2 2.9 4.7 

(5.4) (13.7) (41.4) (.4) (4.6) (6.5) 

N=179 N=275 N=203 N=39 N=130 N=204 

q41_g_parttime Trained Nutrition Paraprofessional : Number of parttime staff (working under 32 hours/wk) (A n.s.; B*)

1.6 2.1 2.0 1.2 1.7 1.8 

(.7) (1.8) (4.8) (.4) (1.2) (1.2) 

N=109 N=144 N=101 N=82 N=116 N=86 

q41_h_fulltime Registered Nurse/Physicians Assistant : Number of full-time staff (working 32- 40+ hours/wk) (A**; B n.s.)

10.8 3.9 2.2 8.3 6.4 3.8 

(18.3) (8.8) (1.8) (16.9) (13.6) (6.6) 

N=318 N=289 N=117 N=233 N=243 N=121 

q41_h_parttime Registered Nurse/Physicians Assistant : Number of part-time staff (working under 32 hours/wk) (A n.s.; B n.s.)

2.0 2.9 2.0 1.9 3.2 1.8 

(1.0) (4.5) (2.4) (1.8) (4.8) (1.6) 

N=152 N=255 N=138 N=230 N=175 N=89 

q41_i_fulltime Physician : Number of full-time staff (working 32- 40+ hours/wk) (A n.s.; B n.s.)

2.0 2.0 1.0 2.0 2.0 -- 

(.0) (.0) (.0) (.0) (.0) -- 

N=32 N=1 N=3 N=20 N=12 N=0 

q41_i_parttime Physician : Number of part-time staff (working under 32 hours/wk) (A--; B n.s.)

1.4 1.0 -- -- -- 2.0 

(.5) (.0) -- -- -- (.0) 

N=11 N=2 N=0 N=0 N=0 N=5 

q41_j_fulltime Social Worker/ Psychologist/ Therapist : Number of full-time staff (working 32- 40+ hours/wk) (A--; B n.s.)

6.3 -- 1.0 5.6 8.0 1.0 

(3.1) -- (.0) (3.4) (.0) (.0) 

N=43 N=0 N=6 N=31 N=12 N=4 

q41_j_parttime Social Worker/ Psychologist/ Therapist : Number of part-time staff (working under 32 hours/wk) (A--; B n.s.)

1.0 5.0 -- -- 1.0 3.0 

(.0) (.0) -- -- (.0) (2.1) 

N=19 N=4 N=0 N=0 N=12 N=9 

q41_k_fulltime Other Professional (non-medical) : Number of full-time staff (working 32- 40+ hours/wk) (A n.s.; B**)

3.2 5.8 2.8 1.0 2.0 4.2 

(3.0) (10.2) (2.7) (.0) (1.1) (8.4) 

N=60 N=111 N=75 N=22 N=45 N=71 

q41_k_parttime Other Professional (non-medical) : Number of part-time staff (working under 32 hours/wk) (A n.s.; B**)

1.5 2.6 1.8 1.0 2.1 1.7 

(1.0) (2.6) (1.0) (.0) (1.3) (.8) 

N=65 N=43 N=53 N=35 N=23 N=49 

q41_l_fulltime Other: PLEASE SPECIFY : Number of full-time staff (working 32- 40+ hours/wk) (A n.s.; B*)

4.5 6.7 6.3 2.7 1.9 2.9 

(8.7) (13.7) (10.2) (1.3) (1.3) (3.2) 

N=113 N=146 N=114 N=43 N=46 N=98 

q41_l_parttime Other: PLEASE SPECIFY : Number of part-time staff (working under 32 hours/wk) (A n.s.; B n.s.)

2.0 2.9 2.2 1.7 1.4 1.9 

(2.0) (10.2) (1.4) (.8) (.9) (1.7) 

N=116 N=116 N=69 N=69 N=95 N=59 
 D-42 National Surv

The relationship of WIC local to State agency Clients served at the whole agency 

State affiliated Local government Non- government <750 750-1,999 2,000-4,500 

q41_M_fulltime Peer Counselor: fulltime staff (working 32- 40+ hours/wk) (A n.s.; B***) 

3.3 3.5 2.3 -- 1.0 1.7 

(2.0) (4.5) (1.2) -- (.0) (.5) 

N=12 N=40 N=16 N=0 N=12 N=12 

q41_M_parttime Peer Counselor: part-time staff (working under 32 hours/wk) (A n.s.; B n.s.)

3.4 3.0 3.0 1.4 4.2 2.8 

(3.1) (4.4) (1.7) (.5) (6.2) (1.1) 

N=26 N=110 N=68 N=31 N=58 N=55 

TOTAL 671 1020 599 578 625 528 Note 1: Averages were calculated for cases with valid data (>0) Note 2: Standard deviations for the averages are in parenthesis. NOTE A applies to the RELATIONSHIP crosstab (columns 1-3): ***p<.0001; **p<.01; *p<.05; n.s. non-significant ; -- N/A for the clients served crosstab. NOTE B applies to the SIZE crosstab (columns 4-7): ***p<.0001; **p<.01; *p<.05 n.s. non-significant; -- N/A for the clients served crosstab. 

Table 30A. WIC Agency Staff: Full-time Equivalent Staff

The relationship of WIC local to State agency Clients served at the whole 

State affiliated Local government Non- government <750 750-1,999 2,00

FTE The number of full-time equivalent staff (A n.s.; B n.s.)

<4 24.2% 31.0% 19.2% 70.2% 28.2% 14-6 22.9% 20.5% 16.3% 10.2% 43.7% 227-10 16.3% 15.3% 19.8% 8.8% 14.3% 3911-24 13.6% 18.7% 26.9% -- 5.7% 325+ 23.0% 14.5% 17.9% 10.8% 8.2% 5

FTE The number of full-time equivalent staff (A n.s.; B*)

<5 29.7% 36.8% 22.9% 74.6% 41.1% 35 to 9 28.8% 26.1% 28.8% 10.9% 43.1% 5210 to 20 16.1% 18.8% 24.4% 3.8% 7.6% 36>20 25.3% 18.3% 24.0% 10.8% 8.2% 8

q43 In all, what is the number of full-time equivalent (FTE) staff who work at your local WIC agency or clinic? (A*; B***)

21.2 15.4 18.6 10.2 11.7 1

(30.6) (28.3) (42.8) (23.7) (23.5) (1

N=671 N=1020 N=599 N=578 N=625 N

TOTAL 671 1020 599 578 625 5Note 1: Averages and percentages were calculated for all cases Note 2: Standard deviations for the averages are in parenthesis. NOTE A applies to the RELATIONSHIP crosstab (columns 1-3): ***p<.0001; **p<.01; *p<.05; n.s. non-significant ; -- N/A for the clients served crosstab. NOTE B applies to the SIZE crosstab (columns 4-7): ***p<.0001; **p<.01; *p<.05 n.s. non-significant; -- N/A for the clients served crosstab.
 D-43 National Surv

Table 31. WIC Agency Staff: Worked at the Agency or Clinic for Less than 2 Years

The relationship of WIC local to State agency Clients served at the whole 

State affiliated Local government Non- government <750 750-1,999 2,00

Q42_a_d WIC Director or Clinic Supervisor (A***; B n.s.)

NO 75.9% 89.4% 89.2% 89.6% 80.9% 9YES 24.1% 10.6% 10.8% 10.4% 19.1% 8

q42_a WIC Director or Clinic Supervisor: Percent (0-100) (A n.s.; B n.s.)

19.9 6.6 8.3 5.1 15.8 

(39.0) (23.2) (26.6) (21.9) (35.2) (2

N=449 N=943 N=518 N=401 N=488 N

Q42_b_d Office Manager (A n.s.; B n.s.)

NO 74.2% 89.6% 82.2% 87.0% 78.3% 84YES 25.8% 10.4% 17.8% 13.0% 21.7% 16

q42_b Office Manager: Percent (0-100) (A n.s.; B n.s.)

24.8 9.2 15.6 13.0 21.7 1

(42.9) (28.7) (35.3) (33.7) (41.3) (3

N=232 N=277 N=232 N=156 N=178 N

Q42_c_d Administrative Support Staff (A n.s.; B*)

NO 51.0% 63.8% 53.5% 74.5% 53.0% 60YES 49.0% 36.2% 46.5% 25.5% 47.0% 39

q42_c Administrative Support Staff: Percent (0-100) (A n.s.; B n.s.)

20.9 15.3 14.7 14.1 22.9 1

(32.3) (26.9) (24.4) (30.0) (33.5) (2

N=559 N=766 N=375 N=357 N=456 N

Q42_d_d Certification Specialist (A**; B**)

NO 51.9% 76.2% 30.9% 80.7% 37.5% 49YES 48.1% 23.8% 69.1% 19.3% 62.5% 50

q42_d Certification Specialist: Percent (0-100) (A**; B n.s.)

32.3 7.8 36.5 15.8 36.1 2

(42.0) (17.4) (39.2) (34.1) (39.6) (3

N=164 N=216 N=156 N=165 N=123 N

Q42_e_d Registered Dietitian (A n.s.; B n.s.)

NO 58.5% 63.1% 64.7% 74.6% 63.3% 60YES 41.5% 36.9% 35.3% 25.4% 36.7% 39

q42_e Registered Dietitian: Percent (0-100) (A n.s.; B n.s.)

24.4 19.4 15.7 23.1 23.0 1

(38.2) (33.6) (29.7) (41.6) (37.8) (3

N=453 N=705 N=444 N=295 N=402 N

Q42_f_d Degreed/Licensed Nutritionist (A*; B***)

NO 65.3% 65.4% 46.7% 82.3% 64.7% 67YES 34.7% 34.6% 53.3% 17.7% 35.3% 32

q42_f Degreed/Licensed Nutritionist: Percent (0-100) (A n.s.; B n.s.)

17.9 16.3 27.5 17.7 19.7 1

(32.3) (30.2) (35.7) (38.2) (34.4) (2

N=368 N=477 N=396 N=222 N=257 N

Q42_g_d Trained Nutrition Paraprofessional (A n.s.; B n.s.)

NO 48.1% 57.7% 50.2% 58.1% 54.6% 56YES 51.9% 42.3% 49.8% 41.9% 45.4% 43

q42_g Trained Nutrition Paraprofessional: Percent (0-100) (A n.s.; B n.s.)

29.6 12.3 22.9 30.5 22.4 1

(41.9) (21.7) (34.7) (38.3) (37.6) (3

N=265 N=345 N=243 N=120 N=208 N

Q42_h_d Registered Nurse/Physicians Assistant (A n.s.; B n.s.)

NO 60.7% 73.8% 68.6% 72.3% 58.9% 76YES 39.3% 26.2% 31.4% 27.7% 41.1% 23
 D-44 National Surv

The relationship of WIC local to State agency Clients served at the whole 

State affiliated Local government Non- government <750 750-1,999 2,00

q42_h Registered Nurse/Physicians Assistant: Percent (0-100) (A n.s.; B n.s.)

22.7 13.3 21.3 16.9 23.8 1

(35.2) (27.8) (38.8) (32.1) (36.0) (3

N=403 N=477 N=200 N=398 N=360 N

Q42_i_d Physician (A --; B n.s.)

NO 14.9% 40.2% 100.0% -- -- YES 85.1% 59.8% -- 100.0% 100.0% 10

q42_i Physician: Percent (0-100) (A n.s.; B***)

71.2 59.8 .0 90.0 90.0 4

(33.9) (59.0) (.0) (.0) (.0) 

N=44 N=3 N=3 N=20 N=12 N

Q42_j_d Social Worker/ Psychologist/ Therapist (A --; B n.s.)

NO 31.5% 100.0% 59.0% 34.4% 25.0% 35YES 68.5% -- 41.0% 65.6% 75.0% 64

q42_j Social Worker/ Psychologist/ Therapist: Percent (0-100) (A**; B n.s.)

57.6 .0 4.1 62.4 60.5 2

(42.5) (.0) (5.2) (45.9) (40.2) (2

N=62 N=4 N=9 N=31 N=24 N

Q42_k_d Other Professional (non-medical) (A n.s.; B n.s.)

NO 79.0% 82.1% 66.7% 100.0% 91.2% 69YES 21.0% 17.9% 33.3% -- 8.8% 30

q42_k Other Professional (non-medical): Percent (0-100) (A n.s.; B n.s.)

10.3 10.0 13.8 .0 8.8 1

(27.1) (26.7) (28.2) (.0) (28.5) (2

N=111 N=132 N=98 N=47 N=62 N

Q42_l_d Other specify (A n.s.; B n.s.)

NO 44.4% 47.2% 38.8% 53.9% 43.2% 55YES 55.6% 52.8% 61.2% 46.1% 56.8% 44

q42_l Other specify: Percent (0-100) (A n.s.; B n.s.)

40.4 28.6 27.8 40.7 41.8 2

(43.7) (38.5) (34.2) (46.3) (45.2) (3

N=203 N=365 N=219 N=110 N=185 N

TOTAL 671 1020 599 578 625 5Note 1: Percentages and averages were calculated for cases that reported having various types of staff. Note 2: Standard deviations for the averages are in parenthesis. NOTE A applies to the RELATIONSHIP crosstab (columns 1-3): ***p<.0001; **p<.01; *p<.05; n.s. non-significant ; -- N/A for the clients served crosstab. NOTE B applies to the SIZE crosstab (columns 4-7): ***p<.0001; **p<.01; *p<.05 n.s. non-significant; -- N/A for the clients served crosstab.
 D-45 National Surv

Table 32. WIC Agency Staff: Difficulties Faced in Retaining, Recruiting and Hiring Staff

The relationship of WIC local to State agency Clients served at the whole age

State affiliated Local government Non- government <750 750-1,999 2,000-4,5

q44_01 Salaries not competitive (A n.s.; B n.s.) 55.3% 50.2% 58.9% 43.5% 55.1% 56.4% q44_02 Benefits not competitive (A**; B n.s.) 10.0% 9.9% 25.0% 12.0% 13.5% 13.3% q44_03 Minimal training and job growth offered

(A n.s.; B n.s.) 11.5% 14.8% 12.8% 4.6% 15.8% 17.8% 

q44_04 Workload too great (A n.s.; B n.s.) 22.6% 23.4% 24.8% 15.8% 21.5% 27.9% q44_05 Location of local agency unsafe

(A n.s.; B n.s.) 1.7% 1.0% 3.5% -- 1.1% 3.4% 

q44_06 Location of local agency hard to get to

(A**; B n.s.) 4.0% 3.2% 12.0% 6.2% 5.9% 5.6% 

q44_07 Physical space occupied by local agency crowded

(A n.s.; B **) 9.4% 16.7% 13.9% 6.7% 9.6% 14.3% 

q44_08 Low employee morale throughout agency

(A***; B n.s.) 18.4% 8.4% 3.5% 9.1% 9.4% 9.2% 

q44_09 Lack of support for WIC program from State

(A n.s.; B n.s.) 7.3% 9.7% 3.2% 6.0% 6.9% 8.0% 

q44_10 Limited career path or opportunities for promotion

(A n.s.; B***) 39.5% 41.9% 38.7% 15.5% 39.6% 47.9% 

q44_11 Required skillset lacking in prospective employees

(A**; B n.s.) 13.0% 16.8% 27.7% 14.9% 20.3% 17.4% 

q44_12 Other: PLEASE SPECIFY: (A n.s.; B n.s.) 11.8% 11.3% 10.2% 14.0% 7.4% 9.8% q44_13 None of the above (A n.s.; B**) 25.7% 23.8% 14.0% 33.6% 22.9% 21.4% TOTAL 671 1020 599 578 625 528 Note: Percentages were calculated for all cases. NOTE A applies to the RELATIONSHIP crosstab (columns 1-3): ***p<.0001; **p<.01; *p<.05; n.s. non-significant ; -- N/A for the clients served crosstab. NOTE B applies to the SIZE crosstab (columns 4-7): ***p<.0001; **p<.01; *p<.05 n.s. non-significant; -- N/A for the clients served crosstab.
 D-46 National Surv

Table 33. WIC Agency Staff: Moderate or Acute Staffing Shortages

The relationship of WIC local to State agency Clients served at the whole age

State affiliated Local government Non- government <750 750-1,999 2,000-4,5

q45_01 Administrative/clerical/support staff

(A*; B n.s.) 29.9% 14.9% 14.1% 17.5% 22.0% 16.9% 

q45_02 Registered Dietitian (A*; B n.s.) 33.0% 20.8% 30.2% 20.4% 19.7% 32.4% q45_03 Degreed/Licensed Nutritionist (A n.s.; B n.s.) 22.2% 12.7% 19.9% 11.9% 12.4% 21.1% q45_04 Trained Nutrition Paraprofessional

(A n.s.; B*) 9.0% 10.5% 6.0% 1.9% 9.3% 10.4% 

q45_05 Registered Nurses/Physicians Assistant

(A*; B***) 19.0% 8.4% 5.4% 20.8% 13.7% 1.5% 

q45_06 Physician (A n.s.; B n.s.) .8% .5% 1.4% -- 1.7% 1.6% q45_07 Social Worker/ Psychologist/ Therapist

(A n.s.; B n.s.) 1.8% .9% 1.1% -- 1.1% 2.6% 

q45_08 Other Professional (A n.s.; B n.s.) .3% 2.0% .3% -- 1.0% 2.6% q45_09 Other: PLEASE SPECIFY: (A n.s.; B n.s.) 3.9% 7.3% 6.2% -- 4.2% 9.3% q45_10 None of the above (A***; B*) 34.9% 56.1% 46.5% 54.8% 52.9% 44.2% TOTAL 671 1020 599 578 625 528 Note: Percentages were calculated for all cases. NOTE A applies to the RELATIONSHIP crosstab (columns 1-3): ***p<.0001; **p<.01; *p<.05; n.s. non-significant ; -- N/A for the clients served crosstab. NOTE B applies to the SIZE crosstab (columns 4-7): ***p<.0001; **p<.01; *p<.05 n.s. non-significant; -- N/A for the clients served crosstab.
 D-47 National Surv

Table 34. WIC Agency Staff: Applicants without English

The relationship of WIC local to State agency Clients served at the whole 

State affiliated Local government Non- government <750 750-1,999 2,00

q46 What percentage of WIC applicants and certificants coming to the agency do NOT speak English well enough to communicate about eligibility, procedures, nutrition, breastfeeding and services? (A n.s.; B***) 

1-0% 9.6% 16.8% 14.0% 43.2% 7.7% 32-1-5% 35.5% 30.4% 30.6% 30.6% 48.1% 323-6-10% 14.5% 8.7% 11.9% 4.1% 10.1% 134-11-20% 13.0% 9.0% 7.1% 6.0% 10.3% 85-21-30% 9.7% 10.6% 11.0% 3.2% 9.0% 156-31-40% 7.4% 9.0% 7.8% 2.6% 6.5% 87-41-50% 3.1% 6.7% 3.8% 6.4% 1.9% 58-51-60% 3.7% 3.2% 2.7% -- 3.8% 19-61-70% -- .9% 3.5% -- -- 310-71-80% 2.5% 1.8% 5.8% 2.6% 1.4% 311-81-90% 1.1% 2.1% .9% 1.5% 1.2% 212-91-100% -- .6% .9% -- -- 2

q46a How confident are you in the range above? (A n.s.; B n.s.)

1-Very confident 63.2% 68.9% 55.6% 84.2% 65.8% 562-Somewhat confident 33.1% 29.7% 40.9% 15.8% 30.3% 393-Not very confident (i.e. a lot of guesswork involved) 3.7% 1.4% 3.5% -- 3.9% 4

TOTAL 671 1020 599 578 625 5Note: Percentages were calculated for all cases. NOTE A applies to the RELATIONSHIP crosstab (columns 1-3): ***p<.0001; **p<.01; *p<.05; n.s. non-significant ; -- N/A for the clients served crosstab. NOTE B applies to the SIZE crosstab (columns 4-7): ***p<.0001; **p<.01; *p<.05 n.s. non-significant; -- N/A for the clients served crosstab.
 D-48 National Surv

Table 35. WIC Agency Staff: Foreign Languages Offered

The relationship of WIC local to State agency Clients served at the whole age

State affiliated Local government Non- government <750 750-1,999 2,000-4,5

q47_01 NONE (A n.s.; B***) 17.3% 16.0% 14.0% 30.1% 21.0% 8.8% q47_02 Arabic (A n.s.; B*) 8.6% 3.8% 10.9% 5.6% 2.3% 7.6% q47_03 Cambodian (A*; B n.s.) 5.2% 1.6% 7.9% 3.6% 2.3% 3.6% q47_04 Cantonese/Mandarin (A**; B**) 8.3% 4.5% 12.8% 3.8% 2.3% 9.7% q47_05 Farsi (A**; B n.s.) 3.3% 2.6% 7.7% -- 2.3% 3.5% q47_06 French/Creole (A*; B**) 9.4% 6.8% 17.3% 5.6% 5.2% 11.3% q47_07 Fulani (A***; B n.s.) 1.9% .6% 5.3% -- 2.3% 2.6% q47_08 Hindi (A*; B**) 7.2% 3.3% 8.9% 3.6% 2.3% 4.2% q47_09 Hmong (A n.s.; B n.s.) 4.9% 4.4% 8.6% 3.8% 2.3% 6.4% q47_10 Khmer (A*; B n.s.) 4.9% 1.1% 6.4% 3.8% 2.3% 2.6% q47_11 Korean (A*; B n.s.) 7.0% 2.5% 10.5% 5.6% 2.3% 6.2% q47_12 Laotian (A n.s.; B n.s.) 5.6% 3.0% 8.0% 3.8% 2.3% 6.5% q47_13 Portuguese (A**; B*) 6.2% 3.4% 11.9% 3.8% 2.3% 7.6% q47_14 Punjabi (A***; B n.s.) 1.6% 1.9% 8.0% -- 2.3% 3.4% q47_15 Russian (A*; B n.s.) 7.3% 4.1% 10.6% 3.8% 3.4% 7.8% q47_16 Somali (A n.s.; B n.s.) 3.9% 2.7% 7.4% 1.9% 2.3% 5.0% q47_17 Spanish (A n.s.; B***) 63.0% 71.9% 76.3% 51.4% 58.3% 81.0% q47_18 Swahili (A*; B n.s.) 2.4% 2.0% 6.6% -- 2.3% 4.1% q47_19 Tamil (A***; B n.s.) 1.6% .3% 5.9% -- 2.3% 3.4% q47_20 Tagalog (A n.s.; B**) 7.4% 5.2% 11.3% 3.8% 3.2% 8.1% q47_21 Urdu (A***; B n.s.) 2.8% 1.5% 9.7% -- 2.3% 4.3% q47_22 Vietnamese (A n.s.; B**) 9.0% 6.2% 12.6% 5.6% 2.3% 10.3% q47_23 Other: SPECIFY (A**; B n.s.) 37.2% 20.9% 26.2% 26.6% 28.5% 25.9% TOTAL 671 1020 599 578 625 528 Note: Percentages were calculated for all cases. NOTE A applies to the RELATIONSHIP crosstab (columns 1-3): ***p<.0001; **p<.01; *p<.05; n.s. non-significant ; -- N/A for the clients served crosstab. NOTE B applies to the SIZE crosstab (columns 4-7): ***p<.0001; **p<.01; *p<.05 n.s. non-significant; -- N/A for the clients served crosstab.
 D-49 National Surv

Table 36. WIC Agency Staff: WIC Population Not Served By Combined Language Capabilities

The relationship of WIC local to State agency Clients served at the whole 

State affiliated Local government Non- government <750 750-1,999 2,00

Q48_D WIC population (applicants, participants, and proxies) not served by combined language capabilities

(A n.s.; B***) 37.2% 36.0% 39.5% 12.7% 37.7% 45

Q48_D2 More than 10% of WIC population (applicants, participants, and proxies) not served by combined language capabilities

(A n.s.; B n.s.) 4.6% 3.6% 4.6% 1.5% 7.3% 4

q48 Approximately what percentage of your WIC population (applicants, participants, and proxies) are not served by your combined language capabilities? (A n.s.; B n.s.)

2.3 3.9 3.6 .6 6.4 

(6.6) (16.3) (13.8) (2.8) (21.6) (1

N=671 N=1020 N=592 N=578 N=618 N

q48a How confident are you in the range above? (A*; B**)

1-Very confident 62.0% 75.6% 60.1% 85.9% 68.6% 62-Somewhat confident 28.6% 20.5% 31.5% 8.7% 22.1% 333-Not very confident (i.e. a lot of guesswork involved) 9.3% 3.9% 7.2% 5.4% 8.2% 5

TOTAL 671 1020 599 578 625 5Note: Percentages were calculated for all cases. NOTE A applies to the RELATIONSHIP crosstab (columns 1-3): ***p<.0001; **p<.01; *p<.05; n.s. non-significant ; -- N/A for the clients served crosstab. NOTE B applies to the SIZE crosstab (columns 4-7): ***p<.0001; **p<.01; *p<.05 n.s. non-significant; -- N/A for the clients served crosstab.
 D-50 National Surv

Table 37. WIC Agency Staff: Languages the Agency Needs to Serve the WIC Population

The relationship of WIC local to State agency Clients served at the whole age

State affiliated Local government Non- government <750 750-1,999 2,000-4,5

q49_01 Arabic (A*; B --)

0-No 95.6% 90.1% 67.8% 100.0% 100.0% 65.7% 1-Yes 4.4% 9.9% 32.2% -- -- 34.3% 

q49_02 Cambodian (A --; B --)

0-No 95.6% 80.3% 100.0% 100.0% 100.0% 100.0% 1-Yes 4.4% 19.7% -- -- -- -- 

q49_03 Cantonese/Mandarin (A --; B --)

0-No 95.6% 100.0% 82.4% 100.0% 100.0% 81.3% 1-Yes 4.4% -- 17.6% -- -- 18.7% 

q49_04 Farsi (A n.s.; B --)

0-No 95.6% 90.1% 85.4% 100.0% 100.0% 84.4% 1-Yes 4.4% 9.9% 14.6% -- -- 15.6% 

q49_05 French/Creole (A --; B --)

0-No 95.6% 79.5% 100.0% 100.0% 100.0% 85.1% 1-Yes 4.4% 20.5% -- -- -- 14.9% 

q49_06 Fulani (A --; B --)

0-No 95.6% 100.0% 100.0% 100.0% 100.0% 100.0% 1-Yes 4.4% -- -- -- -- -- 

q49_07 Hindi (A --; B --)

0-No 95.6% 90.1% 100.0% 100.0% 100.0% 100.0% 1-Yes 4.4% 9.9% -- -- -- -- 

q49_08 Hmong (A --; B --)

0-No 95.6% 100.0% 100.0% 100.0% 100.0% 100.0% 1-Yes 4.4% -- -- -- -- -- 

q49_09 Khmer (A --; B --)

0-No 95.6% 100.0% 100.0% 100.0% 100.0% 100.0% 1-Yes 4.4% -- -- -- -- -- 

q49_10 Korean (A --; B --)

0-No 47.8% 89.4% 100.0% -- 100.0% 61.9% 1-Yes 52.2% 10.6% -- 100.0% -- 38.1% 

q49_11 Laotian (A --; B --)

0-No 95.6% 100.0% 100.0% 100.0% 100.0% 100.0% 1-Yes 4.4% -- -- -- -- -- 

q49_12 Portuguese (A --; B --)

0-No 95.6% 100.0% 87.9% 100.0% 100.0% 100.0% 1-Yes 4.4% -- 12.1% -- -- -- 

q49_13 Punjabi (A --; B --)

0-No 95.6% 90.1% 100.0% 100.0% 100.0% 100.0% 1-Yes 4.4% 9.9% -- -- -- -- 

q49_14 Russian (A --; B --)

0-No 95.6% 100.0% 100.0% 100.0% 100.0% 100.0% 1-Yes 4.4% -- -- -- -- -- 

q49_15 Somali (A n.s.; B --)

0-No 95.6% 94.3% 71.4% 100.0% 100.0% 69.5% 1-Yes 4.4% 5.7% 28.6% -- -- 30.5% 

q49_16 Spanish (A**; B --)

0-No 19.6% 23.8% 86.0% -- 18.9% 85.1% 1-Yes 80.4% 76.2% 14.0% 100.0% 81.1% 14.9% 

q49_17 Swahili (A --; B --)

0-No 72.4% 100.0% 85.4% 100.0% 84.2% 84.4% 1-Yes 27.6% -- 14.6% -- 15.8% 15.6% 

q49_18 Tamil (A --; B --)

0-No 95.6% 100.0% 100.0% 100.0% 100.0% 100.0% 1-Yes 4.4% -- -- -- -- -- 

q49_19 Tagalog (A --; B --)

0-No 95.6% 100.0% 100.0% 100.0% 100.0% 100.0% 1-Yes 4.4% -- -- -- -- -- 
 D-51 National Surv

The relationship of WIC local to State agency Clients served at the whole age

State affiliated Local government Non- government <750 750-1,999 2,000-4,5

q49_20 Urdu (A --; B --)

0-No 95.6% 90.1% 100.0% 100.0% 100.0% 100.0% 1-Yes 4.4% 9.9% -- -- -- -- 

q49_21 Vietnamese (A n.s.; B --)

0-No 67.4% 70.4% 85.4% -- 100.0% 56.9% 1-Yes 32.6% 29.6% 14.6% 100.0% -- 43.1% 

q49_22 Other: SPECIFY (A --; B --)

0-No 80.4% 84.4% 100.0% 100.0% 100.0% 76.8% 1-Yes 19.6% 15.6% -- -- -- 23.2% 

TOTAL 671 1020 599 578 625 528 Note: Percentages were calculated for cases with more than 10% of WIC population (applicants, participants, and proxies) not served by combined language capabilities. NOTE A applies to the RELATIONSHIP crosstab (columns 1-3): ***p<.0001; **p<.01; *p<.05; n.s. non-significant ; -- N/A for the clients served crosstab. NOTE B applies to the SIZE crosstab (columns 4-7): ***p<.0001; **p<.01; *p<.05 n.s. non-significant; -- N/A for the clients served crosstab.Table 38. WIC Agency Participant Characteristics

The relationship of WIC local to State agency Clients served at the whole agency (

State affiliated Local government Non- government <750 750-1,999 2,000-4,500 

q50a Pregnant (A n.s.; B n.s.)

12.0 12.9 13.4 13.0 12.9 13.0 

(5.0) (5.4) (6.5) (6.4) (4.6) (6.7) 

N=671 N=1017 N=599 N=578 N=625 N=528 

q50b Breastfeeding (A**; B n.s.)

5.4 6.8 7.9 6.4 5.6 7.4 

(4.3) (4.2) (4.6) (4.9) (4.0) (4.4) 

N=671 N=1017 N=599 N=578 N=625 N=528 

q50c Postpartum (A n.s.; B*)

9.6 8.7 9.0 9.8 8.8 9.5 

(4.2) (4.3) (4.5) (4.8) (3.3) (5.0) 

N=671 N=1017 N=599 N=578 N=625 N=528 

q50d Infants (A*; B n.s.)

25.0 22.1 22.5 20.3 25.0 23.2 

(7.4) (6.2) (5.0) (7.4) (6.8) (5.3) 

N=671 N=1017 N=599 N=578 N=625 N=528 

q50e Children (A n.s.; B n.s.)

48.0 49.5 47.1 50.5 47.7 46.8 

(12.6) (10.9) (11.7) (14.8) (9.7) (12.1) 

N=671 N=1017 N=599 N=578 N=625 N=528 

TOTAL 671 1020 599 578 625 528 Note 1: Averages were calculated for all cases. Note 2: Standard deviations for the averages are in parenthesis. NOTE A applies to the RELATIONSHIP crosstab (columns 1-3): ***p<.0001; **p<.01; *p<.05; n.s. non-significant ; -- N/A for the clients served crosstab. NOTE B applies to the SIZE crosstab (columns 4-7): ***p<.0001; **p<.01; *p<.05 n.s. non-significant; -- N/A for the clients served crosstab.
 D-52 National Surv

Table 39. WIC Agency Participant Characteristics

The relationship of WIC local to State agency Clients served at the whole 

State affiliated Local government Non- government <750 750-1,999 2,00

q51a_D Hispanic or Latino (A n.s.; B***) 87.2% 94.4% 89.4% 79.3% 91.3% 95q51a Hispanic or Latino (A n.s.; B***)

22.4 26.2 29.8 17.4 20.0 2

(26.1) (28.5) (28.8) (29.5) (23.8) (2

N=671 N=1017 N=592 N=578 N=618 N

q51b_D Not Hispanic or Latino (A n.s.; B n.s.) 99.0% 99.1% 98.9% 100.0% 98.9% 97q51b Not Hispanic or Latino (A n.s.; B***)

77.6 73.8 70.2 82.6 80.0 7

(26.1) (28.5) (28.8) (29.5) (23.8) (2

N=671 N=1017 N=592 N=578 N=618 N

q52a_D American Indian or Alaska Native (A n.s.; B n.s.) 44.8% 46.6% 55.5% 41.2% 43.1% 49q52a American Indian or Alaska Native (A n.s.; B n.s.)

8.5 4.3 5.5 7.1 5.8 

(22.6) (14.8) (13.5) (17.4) (19.9) (1

N=671 N=1017 N=588 N=578 N=618 N

q52b_D Asian American (A**; B***) 52.1% 54.5% 72.4% 23.4% 51.2% 77q52b Asian American (A***; B***)

2.3 2.3 4.1 .7 1.6 

(5.6) (5.1) (9.0) (1.9) (3.4) (

N=671 N=1017 N=588 N=578 N=618 N

q52c_D Black or African American (A n.s.; B***) 89.8% 80.9% 91.8% 70.7% 86.1% 93q52c Black or African American (A***; B*)

30.9 12.5 15.9 13.8 18.3 2

(25.3) (18.1) (21.0) (21.8) (23.6) (2

N=671 N=1017 N=588 N=578 N=618 N

q52d_D Native Hawaiian or Other Pacific Islander (A n.s.; B**) 25.2% 29.5% 33.7% 12.8% 26.4% 32q52d Native Hawaiian or Other Pacific Islander (A n.s.; B*)

1.9 1.0 .7 .2 .7 

(9.0) (5.6) (1.5) (.5) (1.6) (

N=671 N=1017 N=588 N=578 N=618 N

q52e_D White (A n.s.; B n.s.) 96.2% 98.6% 97.5% 97.8% 98.9% 96q52e White (A***; B**)

45.8 68.8 63.2 65.1 65.9 5

(27.1) (29.8) (29.1) (32.0) (29.6) (3

N=671 N=1017 N=588 N=578 N=618 N

q52f_D Multiracial (A n.s.; B*) 80.8% 80.0% 80.8% 69.8% 83.1% 85q52f Multiracial (A n.s.; B n.s.)

10.5 11.0 10.5 13.1 7.6 1

(18.9) (20.2) (15.5) (26.2) (11.7) (1

N=671 N=1017 N=588 N=578 N=618 N

q53a_D Migrant Farm Workers (A n.s.; B***) 33.8% 25.8% 27.3% 12.4% 31.2% 24q53a Migrant Farm Workers (A n.s.; B n.s.)

1.5 1.9 2.7 .3 3.8 

(7.6) (8.6) (11.3) (.9) (14.3) (

N=671 N=1017 N=588 N=578 N=618 N
 D-53 National Surv

The relationship of WIC local to State agency Clients served at the whole 

State affiliated Local government Non- government <750 750-1,999 2,00

q53b_D Homeless (A**; B***) 35.0% 51.9% 61.3% 23.5% 42.0% 66q53b Homeless (A n.s.; B**)

1.5 1.7 2.1 .4 1.8 

(4.2) (4.2) (6.8) (1.2) (4.8) (

N=671 N=1017 N=588 N=578 N=618 N

TOTAL 671 1020 599 578 625 5Note 1: Percentages and averages were calculated for all cases. Note 2: Standard deviations for the averages are in parenthesis. NOTE A applies to the RELATIONSHIP crosstab (columns 1-3): ***p<.0001; **p<.01; *p<.05; n.s. non-significant ; -- N/A for the clients served crosstab. NOTE B applies to the SIZE crosstab (columns 4-7): ***p<.0001; **p<.01; *p<.05 n.s. non-significant; -- N/A for the clients served crosstab.