Wyoming WIC Rights and Responsibilities

As a participant in the Wyoming Women, Infants, and Children (WIC) Program, I understand the following:  

  1. WIC CERTIFICATION is for the following periods: pregnant women until six months post partum; infants/breastfeeding women through the month of the infant’s first birthday; children for six-month periods up to age five years; and non-breastfeeding women through six months post partum.
  2. When my and/or my child(ren)’s certification period ends, WIC Program benefits also end.
  3. I will receive information about food, nutrition, and health, including nutrition education, breastfeeding support, WIC foods, and referral to other health services.
  4. Children receiving WIC benefits must be living with the parent/caregiver who is applying for WIC benefits throughout the period of WIC Certification at least 50% of the time and must meet all WIC Program eligibility criteria.
  5. WIC staff may verify information I have provided. If I provide false information, I may not get WIC benefits; I may have to pay back money for WIC foods already purchased; and I may be prosecuted under state and federal law.
     
  6. Race/ethnicity information is collected for statistical reporting requirements only and does not affect my participation in the WIC Program. Standards for eligibility and participation in the WIC Program are the same for everyone, regardless of race, color, national origin, age, handicap, or sex.
  7. Failure to pick up WIC benefits for three months in a row, or failure to attend recertification appointments, will result in termination from the WIC Program.
  8. The State Health Officer may authorize the use and disclosure of information about my participation in the WIC Program for non-WIC purposes. Such information will be used by state and local WIC offices and public organizations only for program administration and activities such as: to

(A) determine program eligibility of WIC applicants/participants;

(B) conduct outreach;

(C) enhance the health, education, or well-being of WIC applicants/participants;

(D) streamline administrative procedures; and

(E) assess and evaluate Wyoming’s health system in terms of responsiveness to participant healthcare needs and healthcare outcomes.

The caregiver’s electronic signature at WIC Program certification serves as a release of information for this information sharing. 

a.  As stated above, WIC participant information may be shared with the following programs: Children’s Health Services, Kid Care, Best Beginnings, Home Visit Program, Equality Care, Public Health Nursing, Family Planning, Health Check, Lead Poisoning Prevention, Immunizations, and Pregnancy Risk Assessment Monitoring System (PRAMS).

b.  A separate signed Release of Information is required for WIC to share information with any other entity.

PARTICIPANT RIGHTS: 

  1. If I disagree with any decision that affects my WIC eligibility or WIC benefits, I have sixty (60) days from the date of notice to file an appeal and ask for a Fair Hearing to present the reasons for objection by me or by my representative(s), such as a relative/friend/legal counsel or other spokesperson(s). 
  2. Information to request a Fair Hearing may be obtained from any WIC local office or from the Wyoming WIC Program, 6101 North Yellowstone Road, Suite 420, Cheyenne, WY 82002, (307) 777-7494. Continuation of benefits may be requested pending the outcome of the Fair Hearing appeal. The request for continuation of benefits must be filed within 15 days from the date of my Notice of Ineligibility. However, no benefits can be continued beyond a participant’s certification period.

 PARTICIPANT RESPONSIBILITIES:

  1. I will notify WIC staff when I change my address or move to a different city or state.
  2. To avoid loss of WIC benefits, I must attend all WIC appointments with my WYO W.E.S.T. card. 
  3. If I cannot make a WIC appointment, I will call in advance to reschedule. If a benefit pickup class is missed, WIC benefits may be reduced. 
  4. If my WYO W.E.S.T. card is lost or stolen, I will report this to the WIC office immediately. I understand that it is possible the current month’s benefits will not be replaced. 
  5. I will never give my WIC benefits to anyone else.  
  6. I will keep the WYO W.E.S.T. card in a safe place, and I will not give my personal identification number (PIN) to anyone unless it is someone who will make WIC purchases as my additional head of household or proxy. 
     
  7. All formula/medical food exchanges must take place at the WIC office. Any unused infant formula must always be returned to the WIC office. 
  8. I understand that WIC benefits are to be purchased only at WIC authorized stores within the month designated and consumed by the participant for whom they were issued, and that unused benefits do not carry over to future months. 
  9. I am responsible for training my proxy or additional head of household to use the card at the store. I am responsible to ensure that my alternate shopper adheres to these same responsibilities. 
  10. DISQUALIFICATION/SUSPENSION/PROSECUTION/CASH RECOVERY MAY OCCUR FOR:

    a.  Misuse of WIC benefits such as exchanging/selling or intending to sell the WYO W.E.S.T. card or food items purchased with WIC benefits verbally, in print, or online through websites such as Craigslist/Facebook/Twitter/eBay/etc. for cash, credit, or non-food items;

b.  Purchasing/receiving and keeping more WIC foods than authorized or foods not on the WIC Allowable Foods List;

c.  Physical abuse, threat of physical abuse, or verbal abuse to WIC or grocery store staff;

d.  Using a card I have reported as lost or stolen;

e.  Receiving and redeeming WIC food benefits from more than one WIC office in the same month.

The U.S. Department of Agriculture (USDA) prohibits discrimination against its customers, employees, and applicants for employment on the bases of race, color, national origin, age, disability, sex, gender identity, religion, reprisal and, where applicable, political beliefs, marital status, familial or parental status, sexual orientation, or if all or part of an individual's income is derived from any public assistance program, or protected genetic information in employment or in any program or activity conducted or funded by the Department. (Not all prohibited bases will apply to all programs and/or employment activities.)

If you wish to file a Civil Rights program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, found online at http://www.ascr.usda.gov/complaint_filing_cust.html, or at any USDA office, or call (866) 632-9992 to request the form. You may also write a letter containing all of the information requested in the form. Send your completed complaint form or letter to us by mail at U.S. Department of Agriculture, Director, Office of Adjudication, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, by fax (202) 690-7442 or email at program.intake@usda.gov.

Individuals who are deaf, hard of hearing, or have speech disabilities may contact USDA through the Federal Relay Service at (800) 877-8339 or (800) 845-6136 (in Spanish).

USDA is an equal opportunity provider and employer.

The financial and eligibility information I have provided is true to the best of my knowledge including household income, number of household members, address, identification documentation, and information regarding health and nutritional status. I will notify WIC staff immediately of any changes.

By providing my electronic signature in the WIC Horizons system, I confirm the following: (I) my acceptance and knowledge of the statements above; (2) I have been advised of, understand, and have read a copy of the Wyoming WIC Program Participant Rights and Responsibilities; and (3) a paper copy of the Wyoming WIC Program Participant Rights and Responsibilities has been offered to me.