The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides nutritious supplemental foods, healthcare referrals, breastfeeding support, and nutrition education to low-income pregnant, breastfeeding, and postpartum women, infants and children up to age 5 who are at nutritional risk. A Final Rule, Special Supplemental Nutrition Program for Women, Infants, and Children (WIC): Revisions in the WIC Food Packages, was published in the Federal Register on March 4, 2014 (79 FR 12274) that revised the WIC food packages to add a monthly cash-value benefit (CVB) for the purchase of fruits and vegetables. This rule also detailed specific provisions for the value of the CVB, the types of fruits and vegetables authorized, and other State options for providing this benefit. Recent studies have estimated that redemption rates for CVBs range from 73 percent to 77 percent 1, 2; however, the reasons for underredemption of this benefit have not been fully explored. FNS has funded this study to determine the barriers to CVB redemption and the effects of state agency policies, practices, and other factors on CVB redemption rates.
There are a variety of WIC state agency policies and practices that may contribute to CVB underredemption, including but not limited to: vendor authorization and selection policies, the forms of fruits and vegetables allowed, vendor minimum stocking requirements, and participant tools and training available. Other state and household factors may also affect redemption rates, such as geographic access to WIC vendors or household preferences for certain types of fruits and vegetables. In addition, the American Rescue Plan Act of 2021 (ARPA), which was signed into law on March 11, 2021 (PL 117-2), included provisions allowing the USDA to temporarily increase the CVV/B for certain food packages through Sept. 30, 2021. This provision increased the current monthly amounts from $9 for children and $11 for women to up to $35 monthly. 3
On Sept. 30, 2021, Congress passed PL 117-43 (Extending Government Funding and Delivering Emergency Assistance Act) to extend the CVB increase until Dec. 31, 2021. This extension aligned WIC benefit levels with the National Academies of Sciences, Engineering, and Medicine (NASEM) recommendations of $24/month for children, $43/month for pregnant and postpartum participants, and $47/month for breastfeeding participants. On Dec. 2, 2021, Congress passed PL 117-70 (Further Extending Government Funding Act) which further extended the CVB benefit at the NASEM-recommended amounts through March 31, 2022. 4
These increased CVB amounts may reduce barriers to full utilization of the benefit. The temporary CVB increase offers a unique opportunity to test whether CVB redemption rates changed after implementation and whether certain state policy and participant-level factors impacted these rate changes.
In order to identify the factors associated with CVB redemption and examine the effects of state agency policies and practices on CVB redemption rates, FNS is conducting a study in 12 states, with more in-depth data collection occurring in eight of these states. The study will gather data from WIC state agency staff, administrative records, and WIC participants. Administrative record collection will include electronic benefit transfer (EBT) data previously collected from 12 state agencies for the WIC Food Cost Containment Practices study (OMB Number 0584-0627 WIC Food Package Costs and Cost Containment Study, discontinued 09/30/2020) as well as EBT and certification data from eight states for a 11-month period during which states implemented the CVB increase in 2021-2022. EBT data will be used to calculate rates in each of the 12 study state agencies and, in conjunction with the policy data, will be used to assess the ways in which redemption rates vary with differences in policies and practices. Participant and state agency staff interviews in eight of the 12 states will be used to understand the factors that are most salient to participants in making decisions about purchasing fruits and vegetables with their CVB and barriers to redemption.
1 Phillips, D., Bell, L., Morgan, R., & Pooler, J. (2014). Transition to EBT in WIC: Review of impact and examination of participant redemption patterns: Final report. Retrieved from https://altarum.org/sites/default/files/uploaded-publication-files/Altarum_Transition%20to%20WIC%20EBT_Final%20Report_071614.pdf.
2 National Academies of Sciences, Engineering, and Medicine (2017). Review of WIC food packages: Improving balance and choice: Final report. Washington, DC: The National Academies Press. DOI: https://doi.org/10.17226/23655.
3 USDA FNS (2021). WIC Policy Memorandum #2021-3: State Agency Option to Temporarily Increase the Cash-Value Voucher/Benefit for Fruit and Vegetable Purchases. Retrieved from: https://www.fns.usda.gov/wic/policy-memorandum-2021-3.
4 USDA FNS (2021). WIC Policy Memorandum #2022-2: Extending the Temporary Increase in the Cash-Value Voucher/Benefit. Retrieved from: https://www.fns.usda.gov/wic/policy-memo-2022-2-extending-temporary-increase-cash-value-voucher-benefit.