WIC Policies, Procedures, & Forms

Public Health

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WIC Procedure Manual

	Type	Name	Procedure Type
Functional Area : 01. VENDOR ‎(22)
Section : A - Vendor Selection & Authorization ‎(8)
Section : B - Vendor Training ‎(6)
Section : C - High Risk Vendor Identification Systems ‎(1)
Section : D - Routine Monitoring ‎(2)
Section : D - Routine Monitoring Appendix ‎(1)
Section : F - Vendor Sanction System ‎(2)
Section : I - Staff Training on Vendor Management ‎(2)
Functional Area : 02. Nutrition & Breastfeeding (A) (B) (C) ‎(37)
Section : A - Nutrition Education & Breastfeeding ‎(16)
Section : B - Food & Formula ‎(19)
Section : C - Staff Training ‎(2)
Functional Area : 04. Organization & Management ‎(12)
Section : A - State Staffing ‎(1)
Section : B - Evaluation & Selection of Local Agencies ‎(2)
Section : B - Evaluation & Selection of Local Agencies Appendix ‎(2)
Section : C - Local Agency Staffing ‎(1)
Section : E - Clinic Operations, Scheduling, & Forms ‎(6)
Functional Area : 05. Nutrition Services & Admin ‎(17)
Section : A - Funds Allocation ‎(1)
Section : B - Local Agency Budgets ‎(8)
Section : C - Expenditures & Access to Funds ‎(5)
Section : D - Reporting & Reviewing FSR ‎(2)
Section : E - Nutrition Education Costs ‎(1)
Functional Area : 07. Caseload management ‎(9)
Section : A - No Show Rate ‎(1)
Section : E - Outreach Policies & Procedures ‎(5)
Section : F - Waiting List Management ‎(3)
Functional Area : 08. Certification, Eligibility and Coordination of Services ‎(153)
Section : A - Eligibility Determination & Documentation ‎(17)
Section : B - Nutrition Risk Determination, Documentation, & Priority Assignment ‎(13)
Section : B - Nutrition Risk Determination, Documentation, & Priority Assignment Appendix ‎(80)
Section : C - Health Care Agreements, Referrals, & Coordination ‎(6)
Section : D - Processing Standards ‎(2)
Section : E - Certification Periods ‎(8)
Section : F - Transfer of Certification ‎(2)
Section : G - Dual Participation, Participant Rights & Responsibilities, Fair Hearing Procedures, & Sanction System ‎(11)
Section : H - An Overview of WIC Services ‎(3)
Section : I - Application for WIC Benefits ‎(3)
Section : J - Confidentiality ‎(5)
Section : K - Records Management ‎(3)
Functional Area : 09. Food Delivery ‎(17)
Section : B - Check Issuance ‎(7)
Section : C - Check Redemptions & Disposition ‎(2)
Section : C - Replacing eWIC Card ‎(1)
Section : D - Documentation of Check Issuance ‎(1)
Section : E - Special Check Issuance Accommodations ‎(1)
Section : E - Special Issuance Accomodations ‎(1)
Section : F - Special Formula Situations ‎(3)
Section : J - Return of Formula and Food ‎(1)
Functional Area : 10. Monitoring and Audits ‎(3)
Section : A - Monitoring ‎(2)
Section : B - Audits ‎(1)
Functional Area : 11. Civil Rights ‎(11)
Section : A - Administration ‎(3)
Section : B - Public Notification Requirements & Nondiscrimination Notification ‎(5)
Section : D - Data Collection & Reporting ‎(1)
Section : E - Complaint Handling ‎(2)

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Policy Memos

e/WIC Journey use Outside of the Clinic

COVID-19 Policies & Resources

	Type	Name
Category : A. Policy Memos & Forms ‎(18)
Category : B. Other Guidance ‎(10)
Category : C. Job Aid ‎(5)
Category : D. FAQ ‎(3)

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Commonly Used Fillable Forms, Letters, Templates

Clinic Forms

Additional Benefit Issuance Form
Administration Materials Order Form
Educational Materials Order Form
Medicaid Phone Verification Access Request - Confidentiality Statement
Medicaid Web Verification Access Request - Confidentiality Statement
No Proof Fillable Form - Address
No Proof Fillable Form - Identity
No Proof Fillable Form - Income
Requesting Approval to Open, Close, or Move a Clinic
Termination Notice & Ineligibility Notices can be printed in Journey
WIC Infant Enrollment Form

Vendor Change Forms

Complaint Forms

Administrative Forms

USDA Non-Discrimination Phrase

This document contains the USDA Non-Discrimination phrases required on Nebraska WIC materials. For questions about proper use, contact Marge Blankenship at marge.blankenship@nebraska.gov
USDA Non-Discrimination Statement

WIC COVID-19 Resources

	Type	Name
Category : A. Policy Memos & Forms ‎(18)
Category : B. Other Guidance ‎(10)
Category : C. Job Aid ‎(5)
Category : D. FAQ ‎(3)

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WIC Policies, Procedures, & Forms

What would you like to do?

What you need to know

WIC Procedure Manual

Policy Memos

COVID-19 Policies & Resources

Commonly Used Fillable Forms, Letters, Templates

Clinic Forms

Vendor Change Forms

Complaint Forms

Administrative Forms

USDA Non-Discrimination Phrase

WIC COVID-19 Resources

More

More

WIC Policies, Procedures, & Forms // <![CDATA[ _spBodyOnLoadFunctionNames.push("setupPageDescriptionCallout"); // ]]>

What would you like to do?

What you need to know

WIC Procedure Manual

Policy Memos

COVID-19 Policies & Resources​​

​​​Commonly Used Fillable Forms, Letters, Templates

Clinic Forms

Vendor Change Forms

Complaint Forms

Administrative Forms

USDA Non-Discrimination Phrase

WIC COVID-19 Resources

More

WIC Policies, Procedures, & Forms

COVID-19 Policies & Resources

Commonly Used Fillable Forms, Letters, Templates