The WIC Policy-Making Process and Current Issues. Martelle Esposito, MS, MSH National WIC Association March 8, 2015

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The WIC Policy-Making Process and Current Issues Martelle Esposito, MS, MSH National WIC Association March 8, 2015

At Its Core, WIC is about Changing Behavior and Improving Health Nutrition Education * Breastfeeding Education and Support * Referrals to Healthcare and Social Services * Healthy Foods

Social-Ecological Model: What Influences Health Behaviors Policy national, state, and local laws and regulations Community cultural norms and values Organizations/Institutions environment, workplaces, schools, businesses, churches Interpersonal relationships between family, friends, providers, and social networks Individual knowledge, attitudes, and beliefs

Changes to WIC Policy can Help or Hinder Your Ability to Help Clients Achieve Their Goals.

3 Main Policy Areas Appropriations (legislative) Reauthorization (legislative) Food Package (regulatory)

WIC Appropriations

WIC Appropriations Also known as WIC Funding WIC is a discretionary program Congress must fund WIC each year Funding is not guaranteed

Why is the yearly WIC Appropriations process important?

Committees of jurisdiction These are the committees with the power to fund or not fund WIC House Appropriations Committee; Subcommittee on Agriculture, Rural Development, & FDA Senate Appropriations Committees; Subcommittee on Agriculture, Rural Development, & FDA

Committee Leadership House Robert Aderholt (R-AL), Chair, Subcommittee Sam Farr (D-CA), Ranking Member, Subcommittee Harold Rogers (R-KY), Chair, Full Committee Nita Lowey (D-NY), Ranking Member, Full Committee Senate Roy Blunt (R-MO), Chair, Subcommittee Dianne Feinstein (D-CA), Ranking Member, Subcommittee Thad Cochran (R-MS), Chair, Full Committee Barbara Mikulski (D-MD), Ranking Member, Full Committee

We want them to know about how great WIC is and make them our best friends.

Steps in the Appropriations Process President s Budget Request <---currently here in the process Congress s Budget Resolution or Not and the 302 (a) House and Senate Appropriations Committees determine Subcommittee allocations 302 (b)s

Steps in the Appropriations Process House and Senate Agriculture, Rural Development, and FDA Subcommittee markup their versions of the bill, including the WIC program allocation Vote by Subcommittee If passed by Subcommittees, Full Appropriations Committees markup their versions of the bill, including the WIC program allocation Vote by Full Committee

Steps in the Appropriations Process If passed by Full Committee, House and Senate floor debate and amendment on their versions of the bills Vote by House and Senate on the different versions of the bill

Steps in the Appropriations Process If both versions of bill are passed, a Conference Committee is formed Conference Committee irons out differences between 2 versions of the bill Vote by House and Senate on same conferenced bill If passed by House and Senate, bill goes to President Obama for signature or veto

Keep informed about where Congress is in the process! Weekly Legislative Updates NWA s Monday Morning Report All Legislative Updates are posted on NWA s blog to get up to speed on the latest issues

Recent Appropriations Challenges Threats of funding cuts Funding uncertainty with numerous Continuing Resolutions The government shutdown

Continuing Resolutions (CRs) If Congress cannot agree on funding levels for government programs in the coming year, they may enact a Continuing Resolution (CR) Short-term funding to avoid a government shutdown Short-term funding makes program planning challenging

While CRs are not ideal, they are better than letting the government shutdown.

WIC Appropriations FY2015 Funding to meet all caseload needs $60 million: breastfeeding peer counselor program $55 million: MIS/EBT $14 million: Infrastructure $16 million: Program Initiatives and Evaluation FY 2016 President s request Same as FY2015 Level funding request

FY 2016 NWA Appropriations Asks NWA ASKS FOR MORE INVESTMENT IN WIC! Funding to meet all caseload needs $90 million: breastfeeding peer counselor program $80 million: MIS ($30 million)/ebt ($50 million) $14 million: Infrastructure $16 million: Program Initiatives and Evaluation with $5 million for rigorous research $6 million for enhanced breastfeeding CVV

FY2016 Challenge: Sequestration Lower 302 (a) overall funding allocation Likely lower 302 (b) allocation for Appropriations Subcommittee on Agriculture, Rural Development and FDA in FY2016 Each year through FY2021, the overall funding allocation will decrease WIC is the largest program for the Subcommittee, so it is prime for cuts as the Subcommittee s allocation continues to be squeezed

WIC Funding Outlook: Challenging

WIC Reauthorization

WIC Reauthorization Occurs every 5 years Changes WIC Policy Committees of jurisdiction House Education and the Workforce Committee Senate Agriculture Committee

Committee Leadership House : Education and the Workforce Todd Rokita (R-IN), Chair, Subcommittee Marcia L. Fudge (D-OH), Ranking Member, Subcommittee John Kline (R-MN), Chair, Full Committee Robert Bobby Scott (D- VA), Ranking Member, Full Committee Senate : Agriculture John Hoeven (R-ND), Chair, Subcommittee Bob Casey (D-PA), Ranking Member, Subcommittee Pat Roberts (R-KS), Chair, Full Committee Debbie Stabenow (D-MD), Ranking Member, Full Committee

We also want them to know about how great WIC is and make them our best friends.

Examples of Past Reauthorization Policy Change Language to review and update the food package every 10 years The establishment of the Breastfeeding Peer Counselor Program Mandate to get all states to EBT by 2020 The establishment of the use of adjunctive eligibility in WIC Language that establishes funding levels for set asides like the Breastfeeding Peer Counselor Program, MIS/EBT, and Infrastructure

Steps in the Reauthorization Process: Similar to Appropriations process but with new committees Hearings Marker bills introduced House Education and the Workforce Committee/Senate Agriculture Committee mark-ups of their respective bills House and Senate Floor Debate House and Senate vote on their versions of the bill Once passed, the bills are conferenced to iron out differences House and Senate vote on conferenced agreement If passed, bill is signed into law, or vetoed and returned for more work or an override.

NWA Reauthorization Asks: Food Packages Keep food packages based on science and with choice!

NWA Reauthorization Asks: Eligibility Infant certification for 2 years! * Moms until 2 years postpartum! * Children to 6 years old!

NWA Reauthorization Asks: MIS/EBT $85 million for management information systems (MIS) and electronic benefit transfer (EBT)!

NWA Reauthorization Asks: Breastfeeding $180 million per year for breastfeeding peer counselor program! * Double the current amount!

NWA Reauthorization Asks: Cost Containment Preserve the integrity of infant formula cost containment!

NWA Reauthorization Asks: Infrastructure and Research $40 million per year for infrastructure! * $15 million per year for rigorous health outcomes research!

Reauthorization: Potential Challenges Eligibility Adjunctive eligibility Eliminating whole categories of clients, like children Documenting Immigrations Status

WIC Food Packages

WIC Food Packages Regulatory process Reviewed every 10 years USDA seeks recommendations from 3 rd party scientific body, the Institute of Medicine (IOM) At the beginning of the IOM review process

Food Package Rule-making Process USDA begins rule-making process and reaches out to IOM for their expert recommendations IOM reviews food packages IOM releases report of its recommendations to USDA and the public USDA publishes interim rule and accepts public comments USDA responds to all public comments and makes any changes to food packages rule, considering comments USDA publishes interim final rule and accepts public comment USDA responds to all public comments and makes any changes to food packages rule, considering comments USDA publishes final rule Process repeats every 10 years

Essentially, there are opportunities for anyone to provide input throughout process.

Food Package Challenge: Congress deciding to put whatever they want in the food packages rather than go through the rule-making process.

Advocacy

It becomes increasingly important to tell the WIC story to policymakers!

Advocacy vs. Lobbying Advocacy Advocacy refers to speaking out on issues or supporting a proposal or cause. Lobbying Lobbying is one type of advocacy legally defined by the Internal Revenue Service (IRS) A lobbying communication: Refers to specific legislation or measures in a piece of legislation Reflects a view on that legislation, and Involves a communication with any member or employee of a legislative body or any other government official or employee who may participate in the formulation of the legislation (direct lobbying) OR encourages the recipient to contact a legislator, employee of a legislative body, or any other government official or employee (grassroots lobbying)

Non-lobbying Advocacy Educating the public and members of Congress about WIC Highlighting the achievements of WIC clinics in the media Hosting events that promote, celebrate, or inform about WIC

Activity: Lobbying vs. Advocacy The House is voting on a budget bill that would harm WIC, so you call your Congressman and tell him to vote against the bill. You get an NWA action alert to sign a letter stating the benefits of WIC, so you click to email your member of Congress. You do an interview with the local radio station on how funding shortfalls are influencing client services. You host your district s member of Congress at the clinic, explaining all the wonderful aspects of WIC. The Congresswoman ends up talking with a WIC client who is aware of a bill to cut funding for WIC. The client expresses her disapproval. There s a bill to restore funding to WIC, so you tell your friends to call their Congressmen and request support of the bill.

You are Permitted and Encouraged to Lobby It is your democratic right Each state has specific laws for state employees about lobbying efforts while on the job Private money can be used on lobbying, federal funds generally cannot If you are confused.. Limit lobbying efforts to coffee breaks, lunch breaks, after hours and other times not considered work time Focus your time on educating about the value of WIC

During NWA s Leadership Conference you will be educating and doing non-lobbying advocacy.

Now more than ever, we need your voice for WIC families!

Questions? Comments?