An important supplemental nutrition program for young families continues to lose enrollment in Allegheny County, despite recent changes to make the Women, Infants and Children program more user-friendly.
WIC provides financial assistance for groceries to low-income pregnant and postpartum women, and families with children up to age five. All U.S. states are required to transition their WIC programs from paper checks to electronic benefit transfer cards by the end of 2020.
In July 2019, Allegheny County was one of the first 12 Pennsylvania counties to complete this transition. Since then, WIC participation among Allegheny County residents dropped about 6 percent, from 14,343 to 13,431 in January 2020. All Pennsylvania counties have since made the transition.
“Other states that have transitioned to the EBT card have also seen participation decreases after implementation. This could be a result of numerous different factors,” said Nate Wardle, the press secretary at the Pennsylvania Department of Health.
Wardle's comments concur with public policy experts, who said the drop in enrollment was anticipated, as it takes WIC staff time to acclimate to the new EBT system.
Advocates and public policy experts did not say that fewer people need or are eligible for the program; rather, they pointed to barriers to access as a likely cause of the drop in enrollment. WIC mandates in-person appointments with a nutritionist every four months, a requirement that some consider burdensome.
“The appointments are ridiculous,” said WIC participant Amer Lutz of Penn Hills.
Lutz is enrolled in WIC for two of her children, which means she visits an office eight times a year. Though the Turtle Creek location is just a 10-minute drive from her home, Lutz said she missed her last appointment because she had to go to work, and she never knows how long a visit will take.
“It depends on how busy they are, I can sit there an hour and a half, or be out of there in 15 minutes. I never know,” she said.
A white paper put out last year by the Jewish Healthcare Foundation noted that California and Maryland allow some enrollees to attend the quarterly nutrition appointments online. The Department of Health's Nate Wardle said Pennsylvania is looking at options that "may allow for remote nutrition services."
Though some say in-person appointments offer an opportunity to connect some families to needed services.
"If a mother walks into a WIC office and has other issues like transportation, housing, mental health, behavioral health and post-partum depression, WIC has the potential through the screening to lead the mother to different services," said Hanifa Nakiryowa, the white paper's author.
Nakiryowa also recommended that offices do a better job of creating an inviting atmosphere.
“Certain offices aren’t as clean, some are them are down in a dungeon-like basement,” said Taneisha Buice of Homewood, who was enrolled in WIC for all three of her kids until they aged out of the program.
Buice said that WIC was “a great service” and “very helpful” to her as a single mom, as it provided food security, taught her about child nutrition, and even gave her access to a lactation specialist to help her with breastfeeding. But she found it difficult to travel to appointments at the Wilkinsburg office with her children, which took up to an hour by bus.
“When you’re done with it, it’s a relief,” said Buice, “but it’s like damn, I just did all of that, and then I get 10 minutes of warmth and then go out in the cold to get myself home.”
Ann Sanders of Just Harvest also said other possible factors that contribute to declining enrollment include the limited food selection that can be purchased with WIC, and a lack of participating retailers, which she said number roughly 1,400 in Pennsylvania. Also, she said some immigrant families are worried using WIC will affect their ability to reside in the U.S.
All of this is concerning for WIC's future, as subsequent federal funding is tied to current enrollment, which has been declining for years.
"So in Pennsylvania, we're receiving [less money] than we did five years ago, which means there have been staffing cuts," said Ann Sanders, public policy advocate at Just Harvest.
Sanders said the effects of this were felt in Allegheny County, where two of the eight WIC locations temporarily closed in October 2019. The Mt. Oliver and Springdale locations reopened in December and February, respectively.
Statewide WIC participation is the highest its been in nearly two years, so these closures may have had a bigger impact in Allegheny County than did the administrative load of the EBT transition.
Public health analysts and advocates will convene in Harrisburg for a WIC summit on May 4 to discuss how to increase participation in the program.