enrolled in the federal Medicaid, Food Stamp, or Temporary Assistance for Needy Families (TANF) programs are also adjunctively eligible for WIC even if their income exceeds 185 percent of poverty. Applicants must also be determined to be at nutritional risk on the basis of an assessment conducted by a competent professional authority at the WIC site. To be certified as nutritionally at risk, an applicant must meet at least one of the nutritional risk criteria. These risk criteria fall under five broad categories: anthropometric risk (e.g., underweight, obesity); biochemical risk (e.g., low hematocrit); medical risk (e.g., diabetes mellitus); dietary risk (e.g., inappropriate dietary patterns); and predisposing factors (e.g., homelessness). In order to be certified to receive WIC benefits, a person must fit into one of the five categories of eligibility; must have income at or below 185 percent of poverty or be adjunctively eligible for WIC through enrollment in Medicaid, TANF or the Food Stamp Program; and be assessed as nutritionally at risk. The length of certification for WIC depends on the category of eligibility. Pregnant women can be certified from the time they become pregnant through 6 weeks postpartum. Postpartum women are certified for up to 6 months if they are not breastfeeding and up to a year if they breastfeed for more than 6 months. Infants are certified for 6 months or for 1 year—most often for an entire year. Children are usually certified every 6 months.
The federal government gives grants to states and Indian tribal organizations to provide the food, nutrition education, and health and social service referrals, and to administer the program. State food grant allocations are based on the amount the state received in the previous year and the estimated number of eligible persons for that state. States then fund local agencies who actually provide the services to participants.1 If local agencies do not have enough funding to serve all eligible persons who want to participate, they place participants on a prioritized waiting list. Priority is based on the type of nutritional risk and the eligibility category (see U.S. Department of Agriculture, 2001, for information on the WIC priority system). The last year a state had to implement a priority waiting list was 1999. In cases in which states have had shortages of funds to serve all who wanted to participate, supplemental funding was usually obtained from the federal government.