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WIC

Provider Type

  • Physicians
  • Participating Physician Groups (PPG)
  • Hospitals
  • Ancillary

Counties Covered

  • Fresno
  • Kern  
  • Kings
  • Los Angeles
  • Madera
  • Sacramento
  • San Diego 
  • San Joaquin
  • Stanislaus
  • Tulare

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a 100 percent federally funded program that provides nutritious food (via prescriptive checks), individual counseling and nutrition education, breastfeeding promotion and support, and referrals to other needed services to at-risk, low-to-moderate income (up to 185 percent of the federal poverty level) women and children up to age five. The purpose of WIC is to prevent infant mortality, low birth weight and other poor birth outcomes, and to improve the nutrition and health of participants. Primary care physicians (PCPs) inform eligible members of the availability of WIC services during office visits. Refer to the Contacts section in the Provider Library for a listing of WIC office telephone numbers and addresses.

Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) applicants and participants are required to provide the following information when applying for WIC services:

Category

Type of Certification

Height/Length and Weight

Hemoglobin (Hgb) or Hematocrit (Hct) Test

Women

  • prenatal
  • breastfeeding
  • postpartum (non-breastfeeding)

Enrollment and subsequent certification

  • Height/length and weight are required.
  • Data must be current within 60 days of certification.
  • Measures are taken in clinic only if not doing so presents a barrier to services. Whenever possible, WIC appointments are rescheduled to allow clients more time to get medical referrals completed by the health care provider.
  • Blood work must be provided within 90 days of certification. Blood work must be specific to category (for example, a postpartum woman provides results of a blood test taken after delivery).

Infants under age nine months

Enrollment

  • Height/length and weight are required.
  • Birth data recorded on birth certificate or medical record may be used for enrollment in the first 60 days after birth. Orally declared birth data is not acceptable.
  • Measurements are taken at WIC if not otherwise provided.
  • Hgb or Hct test is not required.

Infants nine months and older and children ages one to five

Enrollment

  • Height/length and weight are required.
  • Data must be current within 60 days of enrollment.
  • Certification period may not be shortened based on the date of anthropometric data.
  • Measurements are taken in clinic if not otherwise obtainable.
  • Hgb or Hct testing is required.
  • Blood work must be provided within 90 days of enrollment.
  • Certification periods may not be shortened based on the date of biochemical data.

Children ages one to five

Subsequent certification

  • Height/length and weight are required.
  • Data used for recertification must be current within 60 days of recertification appointment.
  • Measures are taken in clinic only if not doing so presents a barrier to services. Whenever possible, WIC appointments are rescheduled to allow clients more time to get medical referrals completed by the health care provider.
  • Hgb or Hct is required once every 12 months, at a minimum, if Hgb was equal to or greater than 11g/dl or Hct was equal to or greater than 33% at the previous certification.
  • Data must be presented within 90 days of certification.
  • Hgb or Hct is required once every six months, if the Hgb was less than 11 g/dl or Hct was less than 33%.
  • Data used for recertification must be taken during the certification period. If the child's blood values were abnormal at the initial certification, and a follow-up blood test was done during the initial certification period, the follow-up blood test may be used for the following recertification.

Health Net's Medi-Cal members are eligible for Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) services if they are:

  • pregnant
  • breastfeeding (up to one year after childbirth)
  • non-breastfeeding women up to six months after termination of pregnancy (live birth, still birth, fetal death, or miscarriage)
  • children under age five
  • determined by a WIC nutritionist to be at nutritional risk

Medi-Cal members must also:

  • Receive regular medical check-ups.
  • Meet income guidelines.
  • Reside in a local agency's service area.

Providers must document Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) referrals in the member's medical record. The documentation can be a copy of the referral in the member's file or notes in the member's file documenting the visit and subsequent referral.

WIC considers findings and recommendations of WIC referrals to be confidential and declines to share information regarding individual referral findings. WIC has agreed to share aggregate data pending clarification regarding confidentiality from the Department of Agriculture. Until clarification is made, primary care physicians (PCPs) should encourage members to inform PCPs of the outcome of their WIC visits, thereby allowing PCPs to provide appropriate and consistent follow-up and documentation of the outcome of the referral.

The Health Net Medi-Cal Public Programs Coordination Department negotiates a memorandum of understanding (MOU) with local Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) agencies to ensure coordination and communication between Health Net and the WIC agency. Health Net's public programs administrators also work with WIC agency liaisons to resolve any conflicts that might arise between the WIC agency and a Health Net provider or Health Net.

Primary care physicians (PCPs) are responsible for referring eligible members to Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) programs, providing required documentation with each referral and coordinating follow-up care. On request, Health Net or the subcontractor assists in coordinating the WIC referral, including assistance with appointment scheduling in urgent situations.

Referrals for WIC services must be made on one of the following forms:

WIC requires hemoglobin or hematocrit test values at initial enrollment and when participants are recertified. These values are used in assessing eligibility for the WIC program. 

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participants receive a packet of food vouchers each month that they can redeem at the local retail market of their choice for supplemental foods, such as milk, eggs, cheese, cereal, and juice, which provide nutrients essential for healthy pregnancies and children. WIC participants attend monthly nutrition and health education classes and receive nutrition counseling from registered dietitians and nutrition program assistants. WIC also refers participants to other health and social service programs. Federal law requires the WIC program to promote and support breastfeeding.

WIC does not provide medical nutrition therapy. This is the primary care physician's (PCP's) responsibility. WIC does, however, provide nutrition counseling consistent with the physician's plan of care.

WIC does not provide medically necessary or medically indicated formulas to participants enrolled in Medi-Cal managed care plans. Such formulas, which are referred to as therapeutic formulas by WIC, are a benefit under the Medi-Cal managed care program. When prescribing a medically necessary/therapeutic formula, providers must request authorization from their participating physician group (PPG) or Health Net.

Last Updated: 10/31/2019