WIC Coordination With Medicaid and SNAP

More State WIC Programs Collaborating With Other Major Programs To Reach Additional Eligible Low-Income Families With Young Children

Collaboration between the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), Medicaid, and the Supplemental Nutrition Assistance Program (SNAP, formerly food stamps) is an important way to give eligible low-income families with children access to a range of health, nutrition, and supportive services they need to become and stay healthy.[1] By enrolling a greater share of Medicaid and SNAP participants in WIC, states can support healthier pregnancies, improve birth outcomes, and improve child health and cognitive development for low-income families, potentially reducing striking racial disparities.

This report draws on information the Center on Budget and Policy Priorities (CBPP) collected during the summer of 2021 and updated in the summer of 2022 to describe various ways that state WIC agencies are collaborating with their state’s Medicaid and SNAP programs.

WIC provides nutritious foods, nutrition education, breastfeeding support, and referrals to health care and social services to low-income pregnant and postpartum people, infants, and children under age 5. A large body of research demonstrates that WIC improves participants’ health, developmental, and nutrition outcomes.[2] Yet the share of eligible families who participate in WIC has declined over the last decade, and the reach of this critical program appears to have declined further during the COVID-19 pandemic.[3]

WIC works alongside Medicaid and SNAP to help families weather financial distress, improve health and wellness, and boost economic prospects. To simplify eligibility determinations, a WIC applicant who already receives Medicaid or SNAP is automatically considered income-eligible, or adjunctively eligible, for WIC.[4] Medicaid and SNAP enrollees can benefit from WIC’s nutritious foods and services, but many do not participate.[5]

Interest in cross-program collaboration has grown in recent years. More state WIC programs not only collaborate with Medicaid and SNAP, but have entered into written cross-program agreements, which sometimes allow for sharing data that can be used for targeted outreach and streamlined enrollment. This report provides a state-by-state compilation of cross-program collaboration efforts involving WIC, Medicaid, and SNAP. CBPP collected information from states on coordination between WIC and Medicaid and/or SNAP during 2021 and requested updates from them in 2022.[6] Several states that were in the process of developing written agreements or data-sharing practices in 2021 now have them in place and several new states are developing them. Responses from 49 of the 51 WIC geographic state agencies and the District of Columbia[7] show that:

  • At least 34 WIC state agencies periodically meet with Medicaid and/or SNAP officials and one more is in the process of setting up periodic meetings.
  • At least 34 WIC state agencies have a written agreement on coordination or data sharing with Medicaid or SNAP and five more are developing one.
  • At least 30 WIC state agencies periodically (anywhere from daily to annually) receive data on Medicaid and/or SNAP enrollees and eight more are establishing processes to receive data.

In a separate, earlier effort to further explore the possibilities of strengthening cross-program enrollment, CBPP and Benefits Data Trust (BDT) partnered with Colorado, Massachusetts, Montana, and Virginia to conduct pilots during 2018 and 2019 to measure how many people were adjunctively eligible for WIC but not enrolled, and to test whether outreach in the form of a series of text messages could help increase these families’ WIC enrollment. These pilots demonstrated that by matching data across programs to identify families enrolled in Medicaid or SNAP but not WIC, and conducting outreach to them, states can increase WIC enrollment, especially for Medicaid participants, which may improve health and developmental outcomes.[8]

CBPP and BDT subsequently conducted a workshop series for seven additional states that developed workplans to launch or expand data matching and targeted text-based outreach. More recently, Share Our Strength’s No Kid Hungry campaign has provided grants administered by the American Public Human Services Association (APHSA) to several states to better connect SNAP participants with nutrition supports, including WIC. The projects include data matching and analysis across agencies as well as targeted outreach to families likely to be eligible.[9]

Examples in this report of how WIC agencies are collaborating with their state’s Medicaid and SNAP programs can help states that are interested in launching or expanding such collaboration identify other states undertaking similar work and confer with them or draw on the lessons they learned. The state-by-state information compiled in this report can also serve as a baseline going forward, as cross-agency collaboration is likely to become more prevalent and extensive over time.[10]

Assessing the Extent of WIC Coordination With Medicaid and SNAP

Cross-program coordination can take many forms. One common approach is for WIC staff to meet periodically with Medicaid and/or SNAP officials. In addition to facilitating outreach, such collaboration fosters better coordination of services and supports for families participating in more than one program.

A growing number of WIC state agencies have a written agreement with Medicaid or SNAP (such as a data-sharing agreement or memorandum of understanding). A written agreement describing how these programs will coordinate and how to make referrals across programs can benefit both state and local WIC agencies.[11] It may also allow data exchanges and describe the information that will be shared and how often. This allows state WIC agencies to periodically receive files with information about participants in the other program who are eligible for WIC. These files can then be matched with files of WIC enrollees to assess how many WIC-eligible individuals are not enrolled, and state or local WIC agencies can contact those individuals to offer to enroll them.

Though not the focus of this report, collaboration between WIC and Medicaid and/or SNAP also occurs at the local level. Local WIC agencies periodically meet with employees of the other programs to educate them about WIC’s eligibility requirements and services and how to make a referral to WIC. Some WIC local agencies send staff to Medicaid/SNAP offices to conduct direct outreach and help clients apply for WIC. Other local agencies have agreements with the programs to receive contact information of clients who may be eligible for WIC to facilitate targeted outreach to them.

During July and August of 2021, the Center on Budget and Policy Priorities collected information from states on coordination between WIC and Medicaid and/or SNAP. During July and August of 2022, the states were asked to update the information and the D.C. WIC agency was asked to provide it. In our survey, 49 of the 51 WIC state agencies located in geographic states and D.C. responded to questions in 2021 and/or 2022 regarding coordination with Medicaid and SNAP programs in their states:[12]

  • Are there periodic (at least annual) meetings between state-level WIC representatives and representatives from Medicaid and/or SNAP programs?
  • What information about applying for WIC does Medicaid provide to enrollees who may be WIC-eligible?
  • What information about applying for WIC does SNAP provide to enrollees who may be WIC-eligible?
  • Is there a state-level data-sharing agreement or memorandum of understanding between WIC and Medicaid and/or SNAP?
  • Does Medicaid and/or SNAP share data on enrollees with WIC to identify enrollment gaps?
  • If Medicaid and/or SNAP data are shared with WIC, are the data used for targeted outreach by mail, telephone, or text?
  • If Medicaid and/or SNAP data are shared with WIC, how often are they shared?

Their responses show that nearly every WIC state agency collaborates with the Medicaid and/or SNAP programs in their state in some way; three-quarters have or are developing written agreements with another program; and more than two-thirds either currently receive enrollee data from Medicaid, SNAP, or both or are in the process of setting up procedures to receive such data.

Responses from WIC state agencies are summarized below, along with examples of ways WIC works with Medicaid and SNAP to coordinate, establish agreements, and use shared data. Table 1 shows each state’s response to each question.

Cross-Program Collaboration

WIC is usually administered by a different state agency than the agency that administers Medicaid and SNAP, while Medicaid and SNAP are sometimes administered by the same agency, but not always. Thus, coordination often must occur not only across programs, but across agencies. Regular cross-program meetings provide an opportunity to share information, develop referral processes, identify cross-enrollment opportunities, and coordinate outreach and service delivery.

Thirty-five of the 51 WIC state agencies that responded reported that they periodically meet with representatives of Medicaid and/or SNAP or that they are in the process of setting up periodic meetings. In addition, many state agencies indicated that Medicaid and/or SNAP provide their enrollees with information about WIC, ranging from general program information, such as the WIC website or a toll-free WIC phone number, to a link to an online application. WIC state agencies that coordinate with other programs can recommend language for them to use in their communications with enrollees to ensure it is accurate and engaging.

Application processes for Medicaid and SNAP vary across states, with some emphasizing online service more than others. In all scenarios, there are opportunities to make referrals to WIC and provide information about how to apply.

One way to facilitate referrals from other programs to WIC is to incorporate online tools into the WIC certification process for families. These tools range from electronic forms that collect basic contact information or allow an applicant to request a certification appointment to online applications where families enter most of the demographic and basic health information needed for certification, upload eligibility documents, and read and electronically sign required forms.[13] Links to online tools can then be included in the referral materials that Medicaid or SNAP provides to WIC-eligible families.

Several WIC state agencies indicated that they provide the other programs with a link to such an online tool to include in their outreach messages.[14] This approach helps eligible families initiate enrollment in WIC without having to make a phone call or navigate a website to find information about how to enroll. By offering a unique link, WIC state agencies can also monitor whether Medicaid or SNAP enrollees are initiating WIC enrollment.

Including WIC in an online eligibility screener or multi-program application is another way to connect families applying for Medicaid or SNAP with WIC. These are usually set up and operated by state agencies that administer Medicaid and SNAP. Some of these screeners and applications contain information about WIC, but families who may be eligible are often referred to a separate website for information about how to apply. Other multi-program applications allow families to request that their relevant information be shared with WIC to initiate the enrollment process.[15]

Agreements Between WIC and Medicaid and/or SNAP

A written agreement describing how WIC, Medicaid, and/or SNAP will coordinate, how to make referrals across programs, and how data will be shared and used can be beneficial for state and local WIC agencies.[16] Federal law allows Medicaid and SNAP to share enrollee data with WIC, and states have demonstrated that data can be shared securely, protecting families’ privacy while improving their access to essential benefits and services.[17]

Thirty-four WIC state agencies reported that they have a data-sharing agreement or memorandum of understanding with Medicaid or SNAP (as compared to 27 in 2021); an additional five reported that they are in the process of establishing an agreement.[18] (See Figure 1.)

Developing a written agreement that includes data sharing involves staff from multiple programs with expertise in areas including program policy, law, data security, and technology. Thinking through in advance how shared data will be used, and how the impact of those uses will be evaluated, helps states craft strong, secure, and flexible data-sharing agreements.[19] Consulting with states that have a data-sharing agreement in place or with national organizations with relevant experience can help states anticipate key issues and overcome challenges that arise.

Figure 1

Data Sharing Between WIC, Medicaid, and SNAP

Sharing data from Medicaid and SNAP with WIC allows state agencies to measure cross enrollment in the aggregate to assess the extent to which eligible families are missing out on WIC benefits. It also allows for direct outreach to families who are eligible for WIC but not enrolled. If these families enroll in WIC, the certification process may be streamlined because WIC already has information documenting adjunctive eligibility. States interested in launching similar efforts can learn how to effectively conduct data matches and targeted outreach from the states with experience.[20]

State and local agencies use Medicaid and SNAP enrollee data for a variety of purposes, including documenting adjunctive eligibility. Most states have an automated telephone- or web-based system that allows them to check whether a WIC applicant is adjunctively eligible.[21] States with such automated systems do not necessarily have a written agreement in place and do not need to receive batches of data to check applicants’ adjunctive eligibility.

Thirty WIC state agencies report that they or their local agencies periodically receive data on program enrollees from Medicaid and/or SNAP (as compared to 22 in 2021).[22] The frequency of data sharing ranges from daily to annually. An additional eight WIC state agencies are in the process of establishing procedures for receiving data from Medicaid and/or SNAP. (See Figure 2.) Once state and local agencies receive data, they typically use the data either to identify enrollment gaps or to conduct outreach to eligible low-income families.

Figure 2

By matching Medicaid and SNAP enrollee data with WIC enrollee data, state and local WIC agencies can assess the enrollment overlap and gap between programs. Measuring the aggregate enrollment gap allows states to measure progress over time in reaching more adjunctively eligible families. Analyzing which groups are more likely to be missing out on WIC allows states to develop more effective referrals and tailor outreach to underserved groups. Twenty-nine state agencies report that they are using Medicaid and/or SNAP enrollee data to identify WIC enrollment gaps (as compared to 22 in 2021). An additional seven states are in the process of using data from the other programs for this purpose.

Matching Medicaid and SNAP enrollee data with WIC enrollee data also allows state and local WIC agencies to conduct targeted WIC outreach directly to eligible families who are not enrolled. Most states that use Medicaid and SNAP data this way have a written agreement in place that establishes the parameters for sharing and using data.

In 2021, state agencies were asked if the data use agreement or memorandum of understanding between WIC and Medicaid and/or SNAP permitted the data shared with WIC to be used for outreach. Twenty state agencies indicated that the agreement allowed for the Medicaid or SNAP enrollee data to be used by the state or local agencies for targeted WIC outreach.[23] Five additional state agencies were setting up agreements and procedures to use data from one or both of these programs for WIC outreach. In 2022, state agencies were asked not whether data are permitted to be shared but whether data are actually shared with WIC to identify enrollment gaps. The 30 states that are currently receiving Medicaid and/or SNAP data were also asked if they are using the data to conduct targeted outreach. Of those 30 states, 13 states indicated that they are using Medicaid or SNAP data for targeted outreach, employing a combination of text messaging, phone calls, and mail for outreach to Medicaid and/or SNAP enrollees who are not enrolled in WIC. An additional six states are preparing to conduct outreach to Medicaid and/or SNAP enrollees.

In some states, letters with information about WIC and how to apply are sent to families who are eligible for WIC but not enrolled through mass mailings. Other states provide lists with names and contact information for WIC-eligible families to their local agencies to contact by phone. Targeted outreach using text messaging has been successful in reaching and enrolling adjunctively eligible families in WIC.[24] Regardless of the method, procedures for timely outreach and follow-up with respondents, and a mechanism for monitoring the results, are important for successful outreach.

Conclusion

By collaborating with Medicaid and SNAP, which have much more robust take-up by eligible families, state WIC programs can strengthen referrals, measure the extent to which WIC reaches adjunctively eligible families, conduct outreach to enroll more eligible families, and monitor progress over time. By working across agencies to ensure that low-income families with young children receive the full array of benefits and supports for which they are eligible, administrators of each program can help prevent short-term hardship and put children on a healthier course for life.

TABLE 1
State-Level Coordination Between WIC and Medicaid and/or SNAP
Legend:
MED = Medicaid Program; SNP = Supplemental Nutrition Assistance Program; LNK = Link to a pre-application, application, or appointment request; WEB = WIC website; PHN = WIC phone number;
OTH = Other; DNK = Do not know Mail = US Mail, TEL = telephone, TXT = text message DLY = Daily; WKL = Weekly; MTH = Monthly; QTR = Quarterly; SEM = Semi-annually; ANN = Annually
-- = Information not available
State Are there periodic meetings between state-level WIC reps. and reps. from Medicaid and/or SNAP? What information about applying for WIC does Medicaid provide to enrollees who may be WIC-eligible? What information about applying for WIC does SNAP provide to enrollees who may be WIC-eligible? Is there a state-level data- sharing agreement or memo-
randum of understanding between WIC and Medicaid and/or SNAP?
Do Medicaid and/or SNAP share data with WIC to identify enrollment gaps? If Medicaid and/or SNAP data are shared with WIC, are the data used for targeted outreach by mail, telephone, or text? If yes, enter how outreach is done.11 If Medicaid and/or SNAP data are shared with WIC, how often are they shared?
Alabama No DNK DNK MED, SNP MED, SNP No DLY
Alaska Yes DNK DNK No MED, SNP No QTR
Arizona Yes DNK PHN SNP, MED in progress SNP No SEM
Arkansas No DNK DNK MED, SNP No   OTH3
California Yes WEB WEB MED MED No ANN
Colorado1 Yes LNK, WEB, OTH4 LNK, WEB, OTH4 No No    
Connecticut Yes DNK DNK No No    
Delaware No OTH5 OTH5 MED, SNP No    
District of Columbia Yes PHN, WEB PHN, WEB SNP SNP TXT QTR
Florida No DNK DNK MED No    
Georgia Yes WEB WEB MED, SNP MED, SNP No DLY
Hawai’i2 In process DNK DNK SNP In process In process In process
Idaho No PHN, WEB PHN MED, SNP No    
Illinois Yes -- -- No9 In process (SNP) In process (TEL) In process (MTH)
Indiana No No No MED MED No MTH
Iowa Yes DNK DNK No MED Mail, TEL, TXT WKL
Kansas2,10 Yes WEB, OTH5 WEB, OTH5 In process (SNP) In process (SNP) -- In process (WKL)
Kentucky Yes OTH5 OTH5 MED MED Mail MTH3
Louisiana Yes DNK PHN In process In process (MED, SNP) In process (TXT) In process
Maine No No PHN MED, SNP MED, SNP No MTH
Maryland Yes PHN DNK MED No    
Massachusetts1 Yes DNK WEB MED, SNP MED, SNP TXT QTR
Michigan No DNK DNK MED, SNP6 MED, SNP No Ad hoc
Minnesota Yes WEB DNK No MED TXT QTR
Mississippi10 No PHN OTH No No    
Missouri Yes DNK DNK MED, SNP MED, SNP In process (Mail, TXT (SNP only), TEL) In process
Montana1 Yes DNK DNK MED, SNP MED, SNP No Ad hoc
Nebraska Yes No WEB, OTH5 In process In process In process In process
Nevada Yes OTH5 OTH5 MED, SNP MED, SNP No DLY
New Hampshire Yes PHN, WEB PHN, WEB, OTH7 MED, SNP MED, SNP TEL DLY
New Jersey2 Yes No WEB, PHN, LNK SNP SNP No MTH
New Mexico2 Yes OTH5 OTH5 MED, SNP MED, SNP No DLY
New York Yes WEB DNK In process No    
North Carolina Yes DNK LNK In process In process No In process
North Dakota No No No No No    
Ohio Yes OTH5 OTH5 MED, SNP MED, SNP Mail, TEL, TXT MTH
Oklahoma No WEB DNK SNP SNP TXT SEM
Oregon Yes PHN, WEB, LNK PHN, WEB, LNK No No    
Pennsylvania No WEB WEB MED, SNP MED, SNP Mail, TEL, TXT MTH
Rhode Island Yes PHN, WEB 5 PHN, WEB 5 MED, SNP No    
South Carolina Yes OTH5 OTH5 SNP SNP   MTH
South Dakota Yes PHN, WEB, OTH5 PHN, WEB, OTH5 MED, SNP In process (MED, SNP)   DLY7
Tennessee10 -- -- -- -- --   --
Texas Yes PHN, WEB, LNK PHN, WEB, LNK MED, SNP MED, SNP No MTH
Utah12 Yes DNK OTH5 MED, SNP MED, SNP TXT In process
Vermont Yes WEB, OTH5 OTH5 MED MED Mail, TEL MTH, OTH
Virginia1,10 -- -- -- -- --   --
Washington Yes No No MED, SNP MED, SNP In process (TXT) QTR
West Virginia No OTH8 DNK MED MED Mail, in process (TXT) QTR
Wisconsin No LNK, Mail In process No No Mail MTH
Wyoming Yes OTH5 DNK MED, SNP MED No QTR
  1. Colorado, Massachusetts, Montana, and Virginia participated in pilot projects to match WIC enrollee data with enrollee data from Medicaid, SNAP, and/or TANF to identify individuals who are eligible for WIC but not enrolled. These state agencies conducted targeted WIC outreach using text messaging to the households identified. For more information about the pilot project design and results, see Jess Maneely and Zoë Neuberger, “Using Data Matching and Targeted Outreach to Enroll Families With Young Children in WIC,” Center on Budget and Policy Priorities, January 5, 2021, www.cbpp.org/wicpilotreport. For the data-sharing agreement that was in place during Virginia’s pilot project, see National WIC Association, “Data Sharing Agreement for Data Matching and Outreach,” June 14, 2021, https://thewichub.org/data-sharing-agreement-for-data-matching-and-outreach/. The data-sharing agreement that was in place for Colorado’s pilot project has expired. Massachusetts and Montana have continued to conduct data matching and targeted outreach.
  2. Hawai’i, Kansas, New Jersey, and New Mexico WIC state agencies are collaborating with their SNAP state agencies on projects to implement innovations and interagency coordination to combat childhood hunger. See Share Our Strength and APHSA, “Coordinating SNAP and Nutrition Supports to Reduce Child Hunger,” https://files.constantcontact.com/391325ca001/56659579-241a-4278-8812-2f1d98decce0.pdf.
  3. In Arkansas, Medicaid and SNAP enrollee data are shared with local WIC sites for program coordination; in Kentucky, Medicaid data are shared with local sites for outreach.
  4. In Colorado, the multi-program PEAK online application allows applicants to choose to share their information with WIC in addition to applying for Medicaid and SNAP.
  5. Examples of other ways that Medicaid or SNAP programs inform applicants or enrollees about WIC include providing general program information, notifying them that they may be eligible for WIC and making referrals to WIC.
  6. Michigan’s data-sharing agreement is in place for a pilot project to match WIC enrollee data with enrollee data from Medicaid and SNAP to identify individuals who are eligible for WIC but not enrolled. These state agencies conducted targeted WIC outreach using text messaging to a sample of the households identified.
  7. In New Hampshire and South Dakota, Medicaid and SNAP enrollee data are uploaded into the WIC management information system for local sites to check for adjunctive eligibility.
  8. In West Virginia, the managed care organizations include WIC printed materials in welcome packets for Medicaid recipients.
  9. In Illinois, there is no requirement for a data use agreement or memorandum of understanding because WIC, SNAP, and Medicaid all operate within the same government agency.
  10. The responses for Kansas and Mississippi are from 2021. These states did not respond to a request for updates in 2022. Tennessee and Virginia did not provide responses in 2021 or 2022.
  11. This question was revised to ask for outreach methods used, when applicable, for the request to state agencies to provide updates in 2022.
  12. Utah provided updates on data sharing and targeted outreach with Medicaid and SNAP in November 2022.

End Notes

[1] In addition to health care and grocery benefits, these programs provide services such as nutrition education, breastfeeding support, help with smoking cessation, and referrals to additional services.

[2] See Steven Carlson and Zoë Neuberger, “WIC Works: Addressing the Nutrition and Health Needs of Low-Income Families for More Than Four Decades,” CBPP, updated January 27, 2021, www.cbpp.org/wicworks.

[3] Lauren Hall and Zoë Neuberger, “Eligible Low-Income Children Missing Out on Crucial WIC Benefits During Pandemic,” CBPP, July 12, 2021, https://www.cbpp.org/wicpandemicparticipation.

[4] Recipients of Temporary Assistance for Needy Families cash assistance are also adjunctively eligible for WIC. For more details about the adjunctive eligibility rules, see 7. C.F.R. § 246.7 (d)(2)(vi), https://www.law.cornell.edu/cfr/text/7/246.7.

[5] For more information on how Medicaid and SNAP enrollees could benefit from participating in WIC, see Jess Maneely, Benefits Data Trust, and Zoë Neuberger, CBPP, “Matching Data Across Benefit Programs Can Increase WIC Enrollment,” CBPP, April 27, 2021, www.cbpp.org/wicdatamatching. For state examples of the share of Medicaid or SNAP enrollees not enrolled in WIC, see Figure 2, “Substantial Share of Adjunctively Eligible Families Are Not Enrolled in WIC,” https://www.cbpp.org/substantial-share-of-adjunctively-eligible-families-are-not-enrolled-in-wic-0.

[6] The National WIC Association helped solicit responses from WIC state agencies. Linnea Sallack, an independent consultant formerly with the Altarum Institute and the California WIC program, helped compile and summarize state responses. This report draws heavily on earlier work conducted in partnership with Benefits Data Trust and on co-authored reports.

[7] Territories or tribal organizations can serve as state agencies operating the WIC program, but they were not surveyed. Two states (Tennessee and Virginia) did not provide responses in 2021 or 2022. Two states (Kansas and Mississippi) provided responses in 2021 but did not send updates in 2022. Information for D.C. was gathered and added in 2022.

[8] The details of these pilot interventions and results are explained in Jess Maneely and Zoë Neuberger, “Using Data Matching and Targeted Outreach to Enroll Families With Young Children in WIC,” CBPP, January 5, 2021, www.cbpp.org/wicpilotreport.

[9] Grants were provided to Hawai’i, Kansas, Michigan, New Jersey, New Mexico, and Mecklenburg County, North Carolina. Adrienne Carter and Jessica Garon, “RELEASE: No Kid Hungry invests $2 million in innovative SNAP efforts in six states,” No Kid Hungry, April 15, 2021, https://www.nokidhungry.org/who-we-are/pressroom/release-no-kid-hungry-invests-2-million-innovative-snap-efforts-six-states.

[10] In 2020, Congress directed the Agriculture Department to publish state-level estimates of pregnant individuals, infants, and children under age 5 who are participating in Medicaid or SNAP but not WIC. Developing these estimates and the estimates themselves are likely to lead to cross-program collaboration to address the gaps between WIC participation and Medicaid and SNAP. See report submitted by the House Appropriations Committee accompanying the fiscal year 2021 agriculture appropriations bill, “Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Bill, 2021,” Report 116-446, July 13, 2020, p.73, https://www.congress.gov/116/crpt/hrpt446/CRPT-116hrpt446.pdf, and report submitted by the House Appropriations Committee accompanying the fiscal year 2022 agriculture appropriations bill, “Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Bill, 2022,” Report 117-82, July 2, 2021, p. 83, https://www.congress.gov/117/crpt/hrpt82/CRPT-117hrpt82.pdf.

[11] For more information about how to streamline enrollment across programs, see Sonal Ambegaokar, Social Interest Solutions, and Zoë Neuberger and Dorothy Rosenbaum, “Opportunities to Streamline Enrollment Across Public Benefit Programs,” CBPP, November 2, 2017, https://www.cbpp.org/research/poverty-and-inequality/opportunities-to-streamline-enrollment-across-public-benefit.

[12] State agencies operated by territories or tribal organizations were not surveyed.

[13] For more information about tools to facilitate WIC enrollment see CBPP, “Assessing Your WIC Certification Practices,” www.cbpp.org/wiccertificationtoolkit.

[14] Texas, for example, uses an online WIC application. See Texas WIC Program, “Texas WIC Application,” National WIC Association, June 13, 2021, https://thewichub.org/texas-wic-application/.

[15] Colorado, for example, has an online multi-program application that allows applicants to choose to share their information with WIC. Colorado WIC Program, “Colorado Peak Multi-Program Screener and Application and Online WIC Signup,” National WIC Association, June 9, 2021, https://thewichub.org/colorado-peak-multi-program-screener-and-application-and-online-wic-signup/.

[16] For an example of a data-sharing agreement that includes identifying non-enrolled WIC-eligible individuals and conducting targeted outreach to them, see CBPP, “Data Sharing Agreement for Data Matching and Outreach,” National WIC Association, June 14, 2021, https://thewichub.org/data-sharing-agreement-for-data-matching-and-outreach/.

[17] See box, “Securely Sharing Data Across Programs for the Purpose of WIC Outreach Is Allowable,” in Jess Maneely, Benefits Data Trust, and Zoë Neuberger, CBPP, “Matching Data Across Benefit Programs Can Increase WIC Enrollment,” CBPP, April 27, 2021, www.cbpp.org/wicdatamatching.

[18] Florida, Georgia, New Jersey, New Mexico, and Wyoming entered into a data-sharing agreement or memorandum of understanding with Medicaid or SNAP between 2021 and 2022. The District of Columbia was not included in 2021; in 2022 D.C. reported that it has a data-sharing agreement or memorandum of understanding with SNAP.

[19] For a discussion of key considerations when developing a data-sharing agreement, see Maneely and Neuberger, “Matching Data Across Benefit Programs Can Increase WIC Enrollment,” op. cit.

[20] For more information on how to launch or strengthen cross-program data sharing, see Maneely and Neuberger, “Matching Data Across Benefit Programs Can Increase WIC Enrollment,” op. cit.

[21] For more information about each state’s practices for checking for adjunctive eligibility, see Zoë Neuberger, “State WIC Agencies Use Federal Flexibility to Streamline Enrollment,” CBPP, updated April 1, 2022, Table 1, www.cbpp.org/wiccertificationpolicies.

[22] Georgia, Michigan, New Jersey, New Mexico, West Virginia, Wisconsin, and Wyoming report receiving data on program enrollees from Medicaid and/or SNAP in 2022. The District of Columbia was not included in 2021; in 2022 D.C. reported receiving enrollee data from SNAP.

[23] For examples of state initiatives involving cross-program data matching and targeted outreach, see Maneely and Neuberger, “Using Data Matching and Targeted Outreach to Enroll Families With Young Children in WIC,” op. cit.; Carter and Garon, op. cit.

[24] For more information on launching or strengthening targeted text messaging outreach, see Jess Maneely, Benefits Data Trust, and Zoë Neuberger, CBPP, “Targeted Text Message Outreach Can Increase WIC Enrollment, Pilots Show,” CBPP, June 10, 2021, www.cbpp.org/wictexting. For a comparison of these various outreach methods, see Table 2.