Iowa Administrative Code › Agency 641 - Public Health Department › Chapter 73 - Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) › Rule 641-73.19 - Wic Program Violation

Current through Register Vol. 47, No. 3, July 24, 2024
Participants or vendors are subject to the sanctions outlined
				below if determined by contract agency or department staff to be guilty of
				abusing the WIC program or its regulations.
(1)
Participant violation.
Violations may be reported by contract agency staff, vendors, the public, FNS
			 staff, or department staff. All suspected cases of fraud will be investigated
			 by the department. All sanctions will be administered by the department.
			 Contract agencies will be notified of any actions taken against WIC
			 participants by the department.
a. Whenever
			 possible, the participant is contacted via telephone concerning the violation.
			 Documentation is maintained according to procedures set forth in the Iowa WIC
			 Policy and Procedure Manual.
b.
			 Participants who violate WIC program regulations are subject to sanction in
			 accordance with the schedule below:
Violation
Sanction Action
1.
Intentional false statement(s) or misrepresentation of
						  income, name, residence, family size (including receiving and using benefits
						  for children no longer in the family), medical data, pregnancy, and/or date of
						  birth to obtain WIC benefits.
One-year disqualification and pay full
						  restitution
2.
Return of WIC foods to vendor for unapproved food
						  items, nonfood items, credit or cash (attempted or actual). Claim amount less
						  than $100.
Buy, trade, exchange, transfer, sell, or offer to buy,
						  trade, exchange, transfer, sell, or allow any other person to buy, trade,
						  exchange, transfer, sell or offer to buy, trade, exchange, transfer or sell
						  eWIC card/benefits for unapproved food items, nonfood items, cash or favors.
						  Claim amount less than $100.
Two-month disqualification and pay full
						  restitution
Subsequent violation of any claim amount: one-year
						  disqualification and pay full restitution
3.
Return of WIC foods to vendor for unapproved food
						  items, nonfood items, credit or cash (attempted or actual). Claim amount
						  greater than $100.
Buy, trade, exchange, transfer, sell, or offer to buy,
						  trade, exchange, transfer, sell or allow any other person to buy, trade,
						  exchange, transfer, sell or offer to buy, trade, exchange, transfer, or sell
						  WIC foods for unapproved food items, nonfood items, cash or favors. Claim
						  amount greater than $100.
One-year disqualification and pay full
						  restitution
4.
Creating a public nuisance or disrupting normal
						  activities through verbal misconduct or physical disruptions at the local WIC
						  agency, farmers market, or vendor location.
First violation: Education/counseling
Second subsequent violation: Warning letter
Third subsequent violation: Two-month
						  disqualification
Fourth subsequent violation: Any subsequent
						  violation(s) will result in a one-year disqualification.
5.
Verbal abuse or harassment of WIC staff, vendors,
						  farmers market vendors and/or other WIC participants. This includes verbal
						  abuse or harassment in person, on social media, or over the telephone.
Two-month disqualification
Subsequent violation will result in a one-year
						  disqualification.
6.
Physical abuse (directly or indirectly carrying out the
						  actual harm or threatening to do harm) of WIC staff, vendors, vendor staff,
						  farmers market vendors, farmers market vendor staff, and/or other WIC
						  participants.
Any violation will result in a one-year
						  disqualification.
7.
Destruction of property, theft of eWIC card(s) or theft
						  from a local WIC agency, vendor, vendor staff, farmers market vendor, farmers
						  market vendor staff, and/or another WIC participant.
Any violation will result in a one-year
						  disqualification.
8.
Collusion with staff to improperly obtain
						  benefits.
One-year disqualification and pay full
						  restitution
9.
Dual participation resulting from intentional
						  misrepresentation.
One-year disqualification and pay full
						  restitution
10.
Trafficking WIC food benefits, WIC benefits, or WIC
						  items and/or collusion with an authorized vendor.
One-year disqualification and pay full
						  restitution
11.
Other violations of this chapter or the Iowa WIC Policy
						  and Procedure Manual.
As appropriate per this chapter or the Iowa WIC Policy
						  and Procedure Manual
c.
			 Local law enforcement may be notified in appropriate cases.
d. Fifteen days' notice must be given prior
			 to all disqualifications. In all cases, the participant must be informed of the
			 reason for the disqualification, of the right to appeal the decision through
			 the fair hearing process, and of eligibility to receive WIC services at the end
			 of the disqualification period.
e.
			 A disqualification may apply to all members of a family who are on the WIC
			 program.
f. Violations are
			 cumulative. However, a participant will not have sanctions assessed for
			 committing a second violation when the second violation occurs before the
			 participant receives notice of the first violation and the second violation is
			 the same as the first. A participant who commits the same violation a second
			 time following receipt of a notice for the first violation is subject to a
			 one-year disqualification.
g. When
			 a participant improperly received benefits as a result of intentionally making
			 a false or misleading statement(s) or intentionally misrepresenting,
			 concealing, or withholding facts or sells or attempts to sell benefits the
			 participant received from the WIC program and is disqualified from the WIC
			 program, the participant may be required to make restitution of the cash value
			 of the improperly received or used WIC benefits. The department may establish a
			 claim against the participant for the full value of the improperly received
			 benefits.
The department shall issue a written notice of restitution and
				disqualification.
If the participant chooses a repayment plan for claims, the
				department will assist in developing a payment schedule. If the participant has
				not paid the department directly within 30 days of the notice of restitution
				and disqualification, the department will pursue collection of the dollar
				amount owed and benefits will be discontinued until the claim is paid.
h. The department may decide not
			 to impose a mandatory disqualification if a family makes full restitution for a
			 monetary claim, establishes a repayment schedule within 30 days of receipt of
			 the letter demanding repayment, makes full restitution or agrees to a repayment
			 schedule or, in the case of a participant who is an infant, a child, or under
			 the age of 18, the state or local agency approves the designation of a proxy.
			 The department may permit the participant to receive WIC services before the
			 end of a mandatory disqualification period if full restitution is made or a
			 repayment schedule is agreed upon or, in the case of a participant who is an
			 infant, a child, or under the age of 18, the department or local agency
			 approves the designation of a proxy. All decisions are at the discretion of the
			 department.
i. When a
			 disqualification period has ended, the individual disqualified may be
			 reinstated if the individual's certification period is still current. If the
			 individual's certification period is not current, the individual will need to
			 complete a certification appointment.
j. The department shall maintain a master
			 list of all participant violation notices, disqualifications, and statements of
			 restitution. The participant's notice of violation must also indicate when it
			 is a second offense.