Summary

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a federally funded nutrition assistance program run by the Department of Agriculture's Food and Nutrition Service (FNS). This program provides supplemental foods and nutrition services to lower-income pregnant, breastfeeding, and postpartum women; infants; and children up to age 5 who are at nutritional risk. In fiscal year 1999, WIC benefits and services were provided to about 7.3 million individuals each month. To help Congress better understand the cost of administering WIC and delivering nutritional services, GAO is mandated by law to assess various costs associated with WIC nutrition services and administration. This report, the second in a series of such assessments, provides information on: (1) the ways in which WIC agencies deliver nutrition services and administer the program; (2) the ways in WIC which WIC agency staff allocate their time delivering the services and administering the program; and (3) the types of nonprogram resources used and the extent to which such resources cover costs of delivering the nutrition services. GAO's first report was issued in March 2000. (See GAO/RCED-00-66.)

GAO noted that: (1) WIC agencies can vary considerably in the ways they deliver nutrition services and administer the program; (2) for example, the six agencies GAO studied differed in the: (a) manner in which they obtained health information, such as the results of a blood test for anemia, needed to assess the level of participants' nutritional risk; (b) amount and type of nutrition education typically provided to participants; and (c) level and nature of breastfeeding support, such as visiting a new mother in the hospital after delivery; (3) factors affecting the delivery of nutrition services or administration included the state program's policies and procedures, the characteristics of the sponsoring organization, and resource constraints; (4) because WIC agencies differ in how they deliver services and administer the program, the amount of time WIC staff spend on specific activities can vary; (5) for example, at the six agencies, GAO time studies found that the proportion of staff time spent on nutrition services activities as opposed to administrative activities varied greatly; (6) at two agencies, staff spent more than two-thirds of their time on nutrition services activities, while the staff at two other agencies spent less than half of their time on these activities; (7) as a result of this variation, the agencies differed in the amount of time spent in direct contact with participants--either in-person or over the telephone; (8) staff at one agency, for example, spent over 60 percent of their time on activities involving direct contact with participants, while staff at another agency spent about 31 percent; (9) the six WIC agencies GAO studied used a variety of nonprogram resources to deliver WIC services, the most common being in-kind contributions from their sponsoring organizations; (10) the share of costs covered by nonprogram resources at the six agencies ranged from about 20 cents to 2 cents for each dollar in costs covered with program funds; and (11) the extent to which nonprogram resources were used to cover the costs of delivering WIC services did not approach the level of 54 cents for every dollar in costs covered with WIC funds that was cited in a 1988 research study.