Despite operating the program for decades, within a few months the Allegheny County Health Department will no longer be the local provider for the Women, Infants and Children, or WIC Program.
The state has awarded the $3 million annual contract for the program to a Washington County nonprofit. That, along with a relatively short transition time before the switch, has drawn criticism from a number of local legislators and advocates.
WIC aims to provide nutritious food to low-income pregnant women and young children. It's funded through the U.S. Department of Agriculture, and administered by the state Department of Health, which contracts with local organizations to run the aid program. It was implemented in Pennsylvania in 1974. It also offers services like breastfeeding support for mothers and free health screenings.
“I think a number of us have significant questions about the process that took place, how we arrived to this current point,” said state Rep. Austin Davis, D-McKeesport. “And I think at this point, I'd like to see a new process and one that's open and transparent.”
Davis was one of more than a dozen local state representatives, all Democrats, who sent a letter to Gov. Tom Wolf, who is also a Democrat, asking that the state re-run the bidding the process.
“As the sole WIC provider for the majority of the program’s existence, [the Allegheny County Health Department] has developed the extensive infrastructure, culturally-competent staff, and community service integration needed to expand these benefits to a large target population,” the legislators wrote.
They and other legislators have cited issues with how the state accepted bids, how it deemed certain applicant organizations “unresponsive.”
Due to change in state contracts, longtime local WIC providers are also changing in several other counties. The state had not sought competitive bids for the program for many decades prior to last year, because it had previously said only a select group of providers were capable of delivering WIC services. State health officials said they were told by the federal government to competitively bid the program.
Allegheny County is appealing the state’s decision, but the transition to another provider is still moving forward.
“The Allegheny County Health Department has been providing WIC services for decades here in this county and we believe we have an innovative model to continue that for decades to come, and we just want to be able to do that,” said Patrick Dowd, the county Health Department’s chief operating officer. Dowd said in its application to the state, the county had proposed improvements to the program, such as putting WIC offices in hospitals with large maternity units.
A number of advocates have expressed concerns about how the state’s change will impact the mothers and children who receive services from the WIC program.
“The County Health Department has the right to an appeal of the state's decision. That the state expects there to be a smooth, client focused transition in the midst of such an appeal ignores both this right and also places the possibility of client centered transition at jeopardy,” said Ann Sanders, a policy advocate at anti-hunger group Just Harvest. “Both agencies must be focused on the best transition for participants. Progressing or pushing through a transition that is still under review is an unnecessary point of confusion for both participants and agencies.”
Sanders and others have noted the transition was initially scheduled to occur over an 18- month period through October 2022, though it’s been significantly sped up and is now supposed to start in October and be complete by the end of this year.
“My biggest concern is the disruption to WIC participants. These are families disproportionately facing the toll of the pandemic. The state is adding to their stress,” said Lorraine Starsky, a retired public health nurse, who spoke about the change at last month’s Allegheny County Board of Health meeting.
More than 13,000 participants were enrolled in WIC in Allegheny County as of March.
A separate letter to Gov. Wolf from more than two dozen state House and Senate members, both Republicans and Democrats, alleged that the state Department of Health committee that scored proposals and awarded contracts lacked “sufficient background and understanding of WIC programming,” ultimately “[disqualifying] providers which have a long history of providing these services in the community to the ultimate detriment of the constituents who are served.”
A spokesman for the state Department of Health said he couldn’t speak to the committee’s makeup but said selections were made based on the quality of the program applications.
State officials have promised a smooth process for WIC families, despite the changes.
New providers “will not disrupt nutrition services to eligible WIC participants,” Acting Health Secretary Alison Beam said when announcing the changes earlier this year, urging participants not to cancel any appointments. “If your clinic moves, you will be contacted by WIC staff in order to help with your transition and to ensure you continue to receive services.”
State officials have said services will be improved under new agencies – with changes such as more convenient local office locations, extended WIC clinic hours, and options for telehealth visits.
“That's the goal, is to make sure that we're serving those women and children who are already in the program and then expand the participation in every region in the state,” said Barry Ciccocioppo, a spokesman for the state Department of Health.
Pregnant people with low incomes are eligible for the WIC program, and they can receive assistance up to a year post-partum if they are breastfeeding. Infants and children up to age five are also eligible.
The program has been shown to have positive nutrition benefits for children and reduce infant mortality.
However, even advocates for the program agree there are areas for improvement. WIC benefits only reach about half of eligible households in Pennsylvania, participation tends to drop off as children become toddlers. The application for WIC is separate from that of many other public benefit programs, such as food stamps and medical assistance. WIC enrollment has been declining in Pennsylvania, as well as nationally in recent years. The program’s funding is tied to participation, thus declining enrollment leads to declining federal WIC funding to the state.
A 2019 report on WIC from the Jewish Healthcare Foundation noted it is complicated to enroll in WIC and complicated to remain enrolled in the program. That report recommended an investment of additional funds in the program to increase outreach and enrollment; making WIC clinics more child-friendly; and making it easier to participate in WIC with things like walk-in appointments, among other improvements.
